Healthcare Provider Details

I. General information

NPI: 1730894635
Provider Name (Legal Business Name): SOMATIC PATHWAYS COUNSELING, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 01/16/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4606 PLAINFIELD AVE NE
GRAND RAPIDS MI
49525-1229
US

IV. Provider business mailing address

4606 PLAINFIELD AVE NE
GRAND RAPIDS MI
49525-1229
US

V. Phone/Fax

Practice location:
  • Phone: 616-239-2602
  • Fax:
Mailing address:
  • Phone: 616-239-2602
  • 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: MISS JENNIFER GRACE HUNTER
Title or Position: COUNSELOR, OWNER
Credential: LPC
Phone: 616-239-2602