Healthcare Provider Details

I. General information

NPI: 1376427153
Provider Name (Legal Business Name): HARMONY PATH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 PROSPECT AVE SE
GRAND RAPIDS MI
49503-5341
US

IV. Provider business mailing address

601 PROSPECT AVE SE
GRAND RAPIDS MI
49503-5341
US

V. Phone/Fax

Practice location:
  • Phone: 616-259-2764
  • Fax:
Mailing address:
  • Phone: 616-259-2764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ISAIAH GARCIA
Title or Position: CEO/OWNER
Credential: LMSW
Phone: 616-259-2764