Healthcare Provider Details

I. General information

NPI: 1073200671
Provider Name (Legal Business Name): HIRAETH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 04/24/2023
Certification Date: 04/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 E PARIS AVE SE STE 200
GRAND RAPIDS MI
49546-8809
US

IV. Provider business mailing address

1623 ROSSMAN AVE SE
GRAND RAPIDS MI
49507-2241
US

V. Phone/Fax

Practice location:
  • Phone: 616-710-1466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELANIE SZUCS
Title or Position: OWNER
Credential:
Phone: 616-710-1466