Healthcare Provider Details

I. General information

NPI: 1790316867
Provider Name (Legal Business Name): FRESH COAST COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

493 W NORTON AVE STE C
NORTON SHORES MI
49444-3748
US

IV. Provider business mailing address

493 W NORTON AVE STE C
NORTON SHORES MI
49444-3748
US

V. Phone/Fax

Practice location:
  • Phone: 616-319-4389
  • Fax:
Mailing address:
  • Phone: 616-319-4389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: EMILEE A VANLINDEN
Title or Position: OWNER
Credential: LMSW
Phone: 616-212-6316