| Jkg Counseling & Recovery Llc | |
|
233 Fulton St E Ste 114b Grand Rapids MI 49503-3200 | |
| (616) 208-5032 | |
| Not Available |
| Full Name | Jkg Counseling & Recovery Llc |
|---|---|
| Speciality | Counselor |
| Location | 233 Fulton St E Ste 114b, Grand Rapids, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jkg Counseling & Recovery Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Jkg Counseling & Recovery Llc 233 Fulton St E Ste 114b Grand Rapids MI 49503-3200 Ph: (616) 208-5032 |
| NPI Number | 1932724788 |
|---|---|
| Provider Enumeration Date | 06/08/2020 |
| Last Update Date | 06/08/2020 |
| Certification Date | 06/08/2020 |
| Medicare PECOS PAC ID | 5698124741 |
|---|---|
| Medicare Enrollment ID | O20231214000894 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932724788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Kay Gerlofs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265876080 PECOS PAC ID: 6507215654 Enrollment ID: I20231214000971 |
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