Healthcare Provider Details

I. General information

NPI: 1801527528
Provider Name (Legal Business Name): MARIPOSA COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 MONROE AVE NW STE 323
GRAND RAPIDS MI
49505-4674
US

IV. Provider business mailing address

1345 MONROE AVE NW STE 323
GRAND RAPIDS MI
49505-4674
US

V. Phone/Fax

Practice location:
  • Phone: 616-284-1329
  • 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: ALAINA SMITH
Title or Position: OWNER/FOUNDER
Credential: MA, LPC, CAADC, CSAT
Phone: 616-284-1329