Healthcare Provider Details
I. General information
NPI: 1598551608
Provider Name (Legal Business Name): ADELANTE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2025
Last Update Date: 07/13/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1302 LEONARD ST NE
GRAND RAPIDS MI
49505-5513
US
IV. Provider business mailing address
1302 LEONARD ST NE
GRAND RAPIDS MI
49505-5513
US
V. Phone/Fax
- Phone: 616-808-9086
- Fax:
- Phone: 616-808-9086
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSUE
RENATO
GUILLEN
Title or Position: OWNER
Credential: LLMSW
Phone: 616-808-9086