Healthcare Provider Details

I. General information

NPI: 1578120887
Provider Name (Legal Business Name): ERIN CULLUM LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 MONROE CENTER ST NW STE 1104
GRAND RAPIDS MI
49503-2820
US

IV. Provider business mailing address

884 HOLLYWOOD ST NE
GRAND RAPIDS MI
49505-3880
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-8854
  • Fax:
Mailing address:
  • Phone: 616-951-2580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401016361
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: