Healthcare Provider Details

I. General information

NPI: 1447687207
Provider Name (Legal Business Name): DARE TO BE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2013
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 FULTON ST E STE 524
GRAND RAPIDS MI
49503-3269
US

IV. Provider business mailing address

233 FULTON ST E STE 524
GRAND RAPIDS MI
49503-3269
US

V. Phone/Fax

Practice location:
  • Phone: 616-335-0638
  • Fax: 844-697-2585
Mailing address:
  • Phone: 616-335-0638
  • Fax: 844-697-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HEATHER WISZCZUR-JOHNSON
Title or Position: CLINICAL THERAPIST
Credential: LMSW, CAADC
Phone: 616-335-0638