Healthcare Provider Details

I. General information

NPI: 1992366751
Provider Name (Legal Business Name): KILMARTIN COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 ROBINSON RD SE STE 217
GRAND RAPIDS MI
49506-1780
US

IV. Provider business mailing address

1430 ROBINSON RD SE STE 217
GRAND RAPIDS MI
49506-1780
US

V. Phone/Fax

Practice location:
  • Phone: 616-821-2906
  • Fax:
Mailing address:
  • Phone: 616-821-2906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KATIE KILMARTIN
Title or Position: THERAPIST
Credential: LPC
Phone: 616-821-2906