Healthcare Provider Details

I. General information

NPI: 1871420968
Provider Name (Legal Business Name): ROXANNE KRUGER COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 PARMELEE AVE NW
GRAND RAPIDS MI
49504-3842
US

IV. Provider business mailing address

1011 PARMELEE AVE NW
GRAND RAPIDS MI
49504-3842
US

V. Phone/Fax

Practice location:
  • Phone: 517-769-4444
  • Fax:
Mailing address:
  • Phone: 517-769-4444
  • 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: MS. ROXANNE LYNNE KRUGER
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 517-769-4444