| 616 Counseling Professional Corporation | |
|
550 Cascade West Pkwy Se Grand Rapids MI 49546-2137 | |
| (616) 930-4123 | |
| (616) 323-3994 |
| Full Name | 616 Counseling Professional Corporation |
|---|---|
| Speciality | Social Worker |
| Location | 550 Cascade West Pkwy Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Shawn Gauthier (PARTNER & CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6169304123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 616 Counseling Professional Corporation 550 Cascade West Pkwy Se Grand Rapids MI 49546-2137 Ph: (616) 930-4123 | 616 Counseling Professional Corporation 550 Cascade West Pkwy Se Grand Rapids MI 49546-2137 Ph: (616) 930-4123 |
| NPI Number | 1467925222 |
|---|---|
| Provider Enumeration Date | 01/04/2019 |
| Last Update Date | 06/12/2024 |
| Certification Date | 06/12/2024 |
| Medicare PECOS PAC ID | 6901146208 |
|---|---|
| Medicare Enrollment ID | O20190325000834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467925222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shawn L Gauthier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912196270 PECOS PAC ID: 2466535745 Enrollment ID: I20080208000507 |
| Provider Name | Frank Florido |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740480607 PECOS PAC ID: 0042665895 Enrollment ID: I20231013001230 |
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