Healthcare Provider Details

I. General information

NPI: 1750083549
Provider Name (Legal Business Name): KRISTI PAGUIO CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4467 CASCADE RD SE STE 4469
GRAND RAPIDS MI
49546-3776
US

IV. Provider business mailing address

4467 CASCADE RD SE STE 4467
GRAND RAPIDS MI
49546-3776
US

V. Phone/Fax

Practice location:
  • Phone: 773-426-4067
  • Fax:
Mailing address:
  • Phone: 773-426-4067
  • Fax:

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: KRISTI PAGUIO
Title or Position: OWNER/MENTAL HEALTH PROVIDER
Credential: LMSW
Phone: 773-426-4067