Healthcare Provider Details

I. General information

NPI: 1699241356
Provider Name (Legal Business Name): WOHLFORD COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8650 BYRON CENTER AVE SW STE 19
BYRON CENTER MI
49315-9589
US

IV. Provider business mailing address

PO BOX 238
GOWEN MI
49326-0238
US

V. Phone/Fax

Practice location:
  • Phone: 616-536-1938
  • Fax:
Mailing address:
  • Phone: 616-536-1934
  • Fax: 616-333-5370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: THEODORE J WOHLFORD
Title or Position: OWNER
Credential:
Phone: 616-536-1934