Healthcare Provider Details

I. General information

NPI: 1487006102
Provider Name (Legal Business Name): BETHANY ANNE SLUITER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GROVE COLLABORATIVE COUNSELING

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

983 SPAULDING AVE SE
ADA MI
49301-3701
US

IV. Provider business mailing address

7685 ASPENWOOD DR SE
ADA MI
49301-9324
US

V. Phone/Fax

Practice location:
  • Phone: 616-502-0784
  • Fax:
Mailing address:
  • Phone: 616-502-0784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401015446
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: