Healthcare Provider Details

I. General information

NPI: 1285457598
Provider Name (Legal Business Name): EMILY BROUWERS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 KENMOOR AVE SE STE 301
GRAND RAPIDS MI
49546-2395
US

IV. Provider business mailing address

1451 LAKE DR SE # 6062
GRAND RAPIDS MI
49506-1760
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-9142
  • Fax:
Mailing address:
  • Phone: 616-209-9142
  • 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: EMILY BROUWERS
Title or Position: OWNER
Credential: MA, LPC
Phone: 616-209-9142