Healthcare Provider Details

I. General information

NPI: 1124822572
Provider Name (Legal Business Name): DREAM WITH COURAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 WEALTHY ST SE STE 290
GRAND RAPIDS MI
49506-2755
US

IV. Provider business mailing address

2655 GRAND CASTLE BLVD SW APT W608
GRANDVILLE MI
49418-1939
US

V. Phone/Fax

Practice location:
  • Phone: 812-929-6402
  • Fax:
Mailing address:
  • Phone: 812-929-6402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. QUILLIAN DEVON MURPHY
Title or Position: OWNER/ THERAPIST
Credential: PHD
Phone: 812-929-6402