Healthcare Provider Details

I. General information

NPI: 1093356677
Provider Name (Legal Business Name): NEW HOPE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 RAYBROOK ST SE STE 102-2
GRAND RAPIDS MI
49546-7717
US

IV. Provider business mailing address

2020 RAYBROOK ST SE STE 102-2
GRAND RAPIDS MI
49546-7717
US

V. Phone/Fax

Practice location:
  • Phone: 616-822-7881
  • Fax: 616-259-4846
Mailing address:
  • Phone: 616-822-7881
  • Fax: 616-259-4846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER EVANS
Title or Position: OWNER
Credential: LMSW
Phone: 616-866-0727