Healthcare Provider Details

I. General information

NPI: 1154024479
Provider Name (Legal Business Name): LAURA KARL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E BELTLINE AVE SE STE 208
GRAND RAPIDS MI
49546-7673
US

IV. Provider business mailing address

2312 FAIR RIDGE DR NE
ADA MI
49301-8550
US

V. Phone/Fax

Practice location:
  • Phone: 616-320-2254
  • Fax:
Mailing address:
  • Phone: 616-581-6107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: