Healthcare Provider Details

I. General information

NPI: 1184051633
Provider Name (Legal Business Name): RACHEL DUHON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2922 FULLER AVE NE STE 116
GRAND RAPIDS MI
49505-3459
US

IV. Provider business mailing address

2922 FULLER AVE NE STE 116
GRAND RAPIDS MI
49505-3459
US

V. Phone/Fax

Practice location:
  • Phone: 616-208-5256
  • Fax: 616-226-4838
Mailing address:
  • Phone: 616-208-5256
  • Fax: 616-226-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301015087
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401012930
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: