Healthcare Provider Details

I. General information

NPI: 1932013158
Provider Name (Legal Business Name): SKY BLUE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2479 APPLETON DR NE
GRAND RAPIDS MI
49525-3171
US

IV. Provider business mailing address

2479 APPLETON DR NE
GRAND RAPIDS MI
49525-3171
US

V. Phone/Fax

Practice location:
  • Phone: 616-259-5419
  • Fax:
Mailing address:
  • Phone: 616-259-5419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: KATIE RHODES
Title or Position: OWNER
Credential: LPC
Phone: 616-259-5419