Healthcare Provider Details

I. General information

NPI: 1568314508
Provider Name (Legal Business Name): EXHALE THERAPY AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1768 BENJAMIN AVE NE
GRAND RAPIDS MI
49505-5434
US

IV. Provider business mailing address

1768 BENJAMIN AVE NE
GRAND RAPIDS MI
49505-5434
US

V. Phone/Fax

Practice location:
  • Phone: 248-804-7397
  • Fax:
Mailing address:
  • Phone: 248-804-7397
  • 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: CHEYANNA SOMONE GREEN-MOLETT
Title or Position: CLINICAL MENTAL HEALTH COUNSELING
Credential: LPC
Phone: 248-804-7397