Healthcare Provider Details

I. General information

NPI: 1730980848
Provider Name (Legal Business Name): KELSEY RONDEAU COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4519 CASCADE RD SE STE 8
GRAND RAPIDS MI
49546-8319
US

IV. Provider business mailing address

4519 CASCADE RD SE STE 8
GRAND RAPIDS MI
49546-8319
US

V. Phone/Fax

Practice location:
  • Phone: 616-259-5307
  • Fax:
Mailing address:
  • Phone: 616-259-5307
  • 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: KELSEY RONDEAU
Title or Position: OWNER
Credential:
Phone: 616-259-5307