Healthcare Provider Details

I. General information

NPI: 1306156047
Provider Name (Legal Business Name): KALI JO WOLKEN LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS KALI JO FOUTY

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 BYLSMA DR NW
GRAND RAPIDS MI
49534-6828
US

IV. Provider business mailing address

668 BYLSMA DR NW
GRAND RAPIDS MI
49534-6828
US

V. Phone/Fax

Practice location:
  • Phone: 616-540-2099
  • Fax:
Mailing address:
  • Phone: 616-540-2099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002494A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401019178
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: