MEDICARE: ANDREW MICHAEL WOZNICK MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6401225346	MI

General Provider Information

NPI Number	:	1588393870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW MICHAEL WOZNICK MA, LPC

Provider Business Mailing Address
First Line	:	1001 MEDICAL PARK DR SE STE 200
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-3681
Country	:	US
Telephone Number	:	616-259-5326
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 MEDICAL PARK DR SE STE 200
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-3681
Country	:	US
Telephone Number	:	616-259-5326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2022
Last Update Date	:	06/01/2026

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