Immaculate Heart Counseling Pllc | |
156 Valley Ave Sw Grand Rapids MI 49504-6179 | |
(616) 379-9191 | |
Not Available |
Full Name | Immaculate Heart Counseling Pllc |
---|---|
Speciality | Counselor |
Location | 156 Valley Ave Sw, Grand Rapids, Michigan |
Authorized Official Name and Position | William Edward Robinson (OWNER/COUNSELOR) |
Authorized Official Contact | 3016558933 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Immaculate Heart Counseling Pllc 210 Leyden Ave Sw Grand Rapids MI 49504-6129 Ph: (301) 655-8933 | Immaculate Heart Counseling Pllc 156 Valley Ave Sw Grand Rapids MI 49504-6179 Ph: (616) 379-9191 |
NPI Number | 1811764426 |
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Provider Enumeration Date | 12/05/2023 |
Last Update Date | 12/05/2023 |
Certification Date | 12/05/2023 |
Medicare PECOS PAC ID | 2668810839 |
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Medicare Enrollment ID | O20240406000070 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811764426 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | William E Robinson |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1124633185 PECOS PAC ID: 0244687531 Enrollment ID: I20231206002499 |
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