Healthcare Provider Details

I. General information

NPI: 1477477016
Provider Name (Legal Business Name): ASHLEY DOYLE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HALL ST SW STE 185
GRAND RAPIDS MI
49503-6500
US

IV. Provider business mailing address

3425 HIDDEN COVE LN
HUDSONVILLE MI
49426-1647
US

V. Phone/Fax

Practice location:
  • Phone: 616-498-9775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451023921
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: