Healthcare Provider Details

I. General information

NPI: 1396433371
Provider Name (Legal Business Name): COMPASSION COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4496 CLOVERLEAF DR SE
GRAND RAPIDS MI
49546-6221
US

IV. Provider business mailing address

4496 CLOVERLEAF DR SE
GRAND RAPIDS MI
49546-6221
US

V. Phone/Fax

Practice location:
  • Phone: 616-516-2250
  • Fax:
Mailing address:
  • Phone: 616-516-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SALLY VERSTRAETE
Title or Position: OWNER
Credential:
Phone: 616-516-2250