Provider Demographics
NPI:1861575193
Name:LEEMGRAVEN, WARREN N (BS, CAC I)
Entity type:Individual
Prefix:MR
First Name:WARREN
Middle Name:N
Last Name:LEEMGRAVEN
Suffix:
Gender:M
Credentials:BS, CAC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6866 JOAL ST
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-8718
Mailing Address - Country:US
Mailing Address - Phone:616-895-5486
Mailing Address - Fax:
Practice Address - Street 1:6866 JOAL ST
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-8718
Practice Address - Country:US
Practice Address - Phone:616-895-5486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)