Provider Demographics
NPI:1265179659
Name:BUHL, NATASHA JAINA BERNAL (LMSW)
Entity type:Individual
Prefix:
First Name:NATASHA JAINA
Middle Name:BERNAL
Last Name:BUHL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NATASHA JAINA
Other - Middle Name:AGUIRRE
Other - Last Name:BERNAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3215 EAGLE CREST DR NE STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-7005
Mailing Address - Country:US
Mailing Address - Phone:616-219-0316
Mailing Address - Fax:
Practice Address - Street 1:3215 EAGLE CREST DR NE STE 100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7005
Practice Address - Country:US
Practice Address - Phone:616-209-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2025-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011193521041C0700X
68511152451041C0700X
MI68511152451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty