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

Russom Recovery Therapies LLC

Organization Social Worker · NPI 1073154837

Russom Recovery Therapies LLC is a Social Worker in Grand Rapids, Michigan. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4519 Cascade Rd SE Ste 5
Grand Rapids, MI 49546-8319
Phone: (616) 228-2045
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X

Record details

NPI number1073154837
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Beth Houpt — Credentialing · (517) 676-9797
Other names Life Recovery Therapy
NPI enumeratedOctober 3, 2019
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025
Mailing addressPo Box 10, Mason, MI 48854-0010

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