Healthcare Provider Details

I. General information

NPI: 1255257531
Provider Name (Legal Business Name): GREENLEAF COUNSELING AND CONSULTING PROFESSIONALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 W MAIN ST STE 220
KALAMAZOO MI
49009-9263
US

IV. Provider business mailing address

5955 W MAIN ST STE 220
KALAMAZOO MI
49009-9263
US

V. Phone/Fax

Practice location:
  • Phone: 269-806-4601
  • Fax:
Mailing address:
  • Phone: 269-806-4601
  • Fax:

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: MR. RAY BRANDON
Title or Position: PRINCIPLE OWNER
Credential: LPC
Phone: 269-806-4601