Organization · NPI-2
616 Counseling Professional Corporation
Social Worker, Clinical · Grand Rapids, MI
NPI number1467925222
StatusActive
Last updated in NPPESJun 12, 2024
Details
- NPI
- 1467925222
- Entity type
- Organization (NPI-2)
- Legal business name
- 616 Counseling Professional Corporation
- Organization subpart
- No
- Enumeration date
- Jan 4, 2019
- Certification date
- Jun 12, 2024
- Last updated
- Jun 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
| 101YP2500X | Counselor, Professional | – | – |
Practice location
550 Cascade West Pkwy SeGrand Rapids, MI 49546-2137
Phone 616-930-4123 · Fax 616-323-3994
Mailing address
550 Cascade West Pkwy SeGrand Rapids, MI 49546-2137
Phone 616-930-4123
Authorized official
Shawn Gauthier
Partner & Clinical Social Worker
6169304123
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