Healthcare Provider Details

I. General information

NPI: 1770237448
Provider Name (Legal Business Name): NEW STORY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5242 PLAINFIELD AVE NE STE C
GRAND RAPIDS MI
49525-1084
US

IV. Provider business mailing address

5242 PLAINFIELD AVE NE STE C
GRAND RAPIDS MI
49525-1084
US

V. Phone/Fax

Practice location:
  • Phone: 616-920-0428
  • Fax: 616-734-6205
Mailing address:
  • Phone:
  • 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: JENNIFER BELMONTE
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential:
Phone: 616-920-0428