Healthcare Provider Details
I. General information
NPI: 1699459172
Provider Name (Legal Business Name): PEAK COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/14/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
40 PEARL ST NW STE 341
GRAND RAPIDS MI
49503-3026
US
IV. Provider business mailing address
40 PEARL ST NW STE 341
GRAND RAPIDS MI
49503-3026
US
V. Phone/Fax
- Phone: 708-420-4989
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REBECCA
MCDANIEL
Title or Position: OWNER
Credential: LMSW
Phone: 708-420-4989