Healthcare Provider Details

I. General information

NPI: 1437590353
Provider Name (Legal Business Name): ASHLEY NICHOLS VANBEMMELEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY ANN NICHOLS LPC

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 PARCHMENT DR SE STE 100
GRAND RAPIDS MI
49546
US

IV. Provider business mailing address

7589 TANNON TRL SE
ALTO MI
49302-9566
US

V. Phone/Fax

Practice location:
  • Phone: 616-294-0040
  • Fax:
Mailing address:
  • Phone: 616-294-0040
  • Fax: 844-296-0280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401013458
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401013458
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401013458
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: