Provider Demographics
NPI:1053419994
Name:SCHURINK, DICK JAN (LMSW)
Entity type:Individual
Prefix:MR
First Name:DICK
Middle Name:JAN
Last Name:SCHURINK
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4436 BARD ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49461
Mailing Address - Country:US
Mailing Address - Phone:231-766-5937
Mailing Address - Fax:
Practice Address - Street 1:376 E APPLE AVENUE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442
Practice Address - Country:US
Practice Address - Phone:231-724-1111
Practice Address - Fax:231-724-6042
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010770341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDS077034OtherBCBS PIN