Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Russom Recovery Therapies LLC

Organization Social Worker · NPI 1073154837

Russom Recovery Therapies LLC provides Social Worker services 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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