Healthcare Provider Details
I. General information
NPI: 1376103036
Provider Name (Legal Business Name): COVILLE COUNSELING AND ASSESSMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2019
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
826 PARCHMENT DR SE STE 205
GRAND RAPIDS MI
49546-2307
US
IV. Provider business mailing address
826 PARCHMENT DR SE STE 205
GRAND RAPIDS MI
49546-2307
US
V. Phone/Fax
- Phone: 616-893-0983
- Fax: 616-930-4669
- Phone: 616-893-0983
- Fax: 616-930-4669
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
COVILLE
Title or Position: PSYCHOLOGIST
Credential: MA LLP
Phone: 616-893-0983