Healthcare Provider Details

I. General information

NPI: 1841803517
Provider Name (Legal Business Name): DIGNITY COUNSELING & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 01/18/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 E BELTLINE CT NE
GRAND RAPIDS MI
49525-9494
US

IV. Provider business mailing address

3280 E BELTLINE CT NE
GRAND RAPIDS MI
49525-9494
US

V. Phone/Fax

Practice location:
  • Phone: 231-510-3675
  • Fax:
Mailing address:
  • Phone: 231-510-3675
  • 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: MS. AMY MARSH SULLIVAN
Title or Position: OWNER
Credential: MA, LPC
Phone: 231-510-3675