Healthcare Provider Details

I. General information

NPI: 1417829656
Provider Name (Legal Business Name): COURAGEOUS COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 LINCOLNSHIRE LN SE
GRAND RAPIDS MI
49546-7166
US

IV. Provider business mailing address

2880 LINCOLNSHIRE LN SE
GRAND RAPIDS MI
49546-7166
US

V. Phone/Fax

Practice location:
  • Phone: 518-217-8159
  • Fax:
Mailing address:
  • Phone: 518-217-8159
  • Fax: 616-328-6591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSHUA YAO ZHENG
Title or Position: OWNER
Credential: MS
Phone: 518-217-8159