Healthcare Provider Details

I. General information

NPI: 1194200345
Provider Name (Legal Business Name): CLEAR VISIONS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 08/07/2020
Certification Date: 08/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 KALAMAZOO AVE SE SUITE C
CALEDONIA MI
49316
US

IV. Provider business mailing address

7150 KALAMAZOO AVE SE SUITE C
CALEDONIA MI
49316
US

V. Phone/Fax

Practice location:
  • Phone: 616-466-8357
  • Fax:
Mailing address:
  • Phone: 616-446-8357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WESLEY WASHINGTON
Title or Position: OWNER
Credential: LPC
Phone: 616-466-8357