Healthcare Provider Details

I. General information

NPI: 1639839335
Provider Name (Legal Business Name): DUMAR COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 01/14/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MONROE AVE NW STE 202
GRAND RAPIDS MI
49503-1448
US

IV. Provider business mailing address

6973 BREWER AVE NE
ROCKFORD MI
49341-9213
US

V. Phone/Fax

Practice location:
  • Phone: 586-215-3435
  • Fax:
Mailing address:
  • Phone: 586-215-3435
  • 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: MARCIE DULLEA
Title or Position: OWNER
Credential: LPC
Phone: 586-215-3435