Provider Demographics
NPI:1861930158
Name:ACORN HILL PSYCHOLOGY PLLC
Entity type:Organization
Organization Name:ACORN HILL PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:616-443-6270
Mailing Address - Street 1:7150 KALAMAZOO AVE SE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-4625
Mailing Address - Country:US
Mailing Address - Phone:616-219-0159
Mailing Address - Fax:616-219-0124
Practice Address - Street 1:7150 KALAMAZOO AVE SE
Practice Address - Street 2:SUITE C
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316
Practice Address - Country:US
Practice Address - Phone:616-219-0159
Practice Address - Fax:616-219-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty