Healthcare Provider Details

I. General information

NPI: 1235072067
Provider Name (Legal Business Name): FOREST RIVER COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 28TH ST SE STE 230
GRAND RAPIDS MI
49546-6938
US

IV. Provider business mailing address

6140 28TH ST SE STE 230
GRAND RAPIDS MI
49546-6938
US

V. Phone/Fax

Practice location:
  • Phone: 616-466-3302
  • Fax:
Mailing address:
  • Phone: 616-466-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: HEATHER ROSE JORDAN
Title or Position: OWNER
Credential: LPC, CAADC
Phone: 616-466-3302