Healthcare Provider Details

I. General information

NPI: 1841183779
Provider Name (Legal Business Name): PARTNERSHIP FOR HOPE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 GRACELAND ST NE
GRAND RAPIDS MI
49505-6251
US

IV. Provider business mailing address

119 GRACELAND ST NE
GRAND RAPIDS MI
49505-6251
US

V. Phone/Fax

Practice location:
  • Phone: 406-471-6831
  • Fax:
Mailing address:
  • Phone: 406-471-6831
  • 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: ASHLEY JO SHACKELTON
Title or Position: THERAPIST
Credential: LMSW
Phone: 406-471-6831