Healthcare Provider Details

I. General information

NPI: 1407724388
Provider Name (Legal Business Name): JOHN KING PROFESSIONAL COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E BELTLINE AVE NE STE 300
GRAND RAPIDS MI
49506-1267
US

IV. Provider business mailing address

330 E BELTLINE AVE NE STE 300
GRAND RAPIDS MI
49506-1267
US

V. Phone/Fax

Practice location:
  • Phone: 616-898-2656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN KING
Title or Position: OWNER
Credential: LPC
Phone: 616-898-2656