Healthcare Provider Details

I. General information

NPI: 1740192228
Provider Name (Legal Business Name): JAMES TRIUMPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 E MICHIGAN AVE STE 400
KALAMAZOO MI
49007-3950
US

IV. Provider business mailing address

161 E MICHIGAN AVE STE 400
KALAMAZOO MI
49007-3950
US

V. Phone/Fax

Practice location:
  • Phone: 269-929-7486
  • Fax:
Mailing address:
  • Phone: 269-929-7486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451025359
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: