Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cherry Street Services Inc

Organization Clinical Neuropsychologist · NPI 1043592629

Cherry Street Services Inc is a Clinical Neuropsychologist in Grand Rapids, Michigan. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
8
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1400 Leonard St NE
Grand Rapids, MI 49505-5515
Phone: (616) 954-1991
Fax: (616) 954-1998
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Clinical Neuropsychologist Taxonomy 103G00000X
Counseling Psychologist Taxonomy 103TC1900X
Clinical Social Worker Taxonomy 1041C0700X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Pediatric Adolescent Medicine Physician Taxonomy 2080A0000X
Mobile Radiology Clinic/Center Taxonomy 261QR0208X

Record details

NPI number1043592629
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCherry Street Services Inc
Authorized official Tasha Blackmon — Executive Director · (616) 776-2121
Other names Leonard Street Counseling Center; Leonard Street Counseling Center
NPI enumeratedSeptember 9, 2011
Last updated in NPPESOctober 1, 2021
Certification dateOctober 1, 2021
Mailing address100 Cherry St Se, Grand Rapids, MI 49503-4748

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