Healthcare Provider Details

I. General information

NPI: 1245141084
Provider Name (Legal Business Name): GREEN GRASS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 STRAIGHT AVE SW
GRAND RAPIDS MI
49504-6334
US

IV. Provider business mailing address

47 STRAIGHT AVE SW
GRAND RAPIDS MI
49504-6334
US

V. Phone/Fax

Practice location:
  • Phone: 616-202-2698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELIZABETH GHEKIERE
Title or Position: LICENSE PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 616-202-2698