Healthcare Provider Details

I. General information

NPI: 1225746969
Provider Name (Legal Business Name): DOVE OF PEACE CHRISTIAN COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2022
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8811 VERNIER RD
IRA MI
48023-2909
US

IV. Provider business mailing address

8811 VERNIER RD STE A
IRA MI
48023-2909
US

V. Phone/Fax

Practice location:
  • Phone: 586-307-4659
  • Fax: 586-500-9584
Mailing address:
  • Phone: 586-307-4659
  • Fax: 586-500-9584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY M GRETTENBERGER
Title or Position: OWNER
Credential:
Phone: 586-443-1834