Healthcare Provider Details
I. General information
NPI: 1013718667
Provider Name (Legal Business Name): AUDREY AUKEMAN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
826 PARCHMENT DR SE STE 100
GRAND RAPIDS MI
49546-2307
US
IV. Provider business mailing address
826 PARCHMENT DR SE STE 100
GRAND RAPIDS MI
49546-2307
US
V. Phone/Fax
- Phone: 616-202-6514
- Fax:
- Phone: 616-202-6514
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AUDREY
AUKEMAN
Title or Position: OWNER
Credential: LPC
Phone: 616-430-4010