Healthcare Provider Details

I. General information

NPI: 1194643312
Provider Name (Legal Business Name): DEVELOPING POTENTIAL COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8808 GRAND RIVER AVE
SARANAC MI
48881-9820
US

IV. Provider business mailing address

PO BOX 156
EAU CLAIRE MI
49111-0156
US

V. Phone/Fax

Practice location:
  • Phone: 616-303-0253
  • Fax:
Mailing address:
  • Phone: 616-303-0253
  • 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: AMANDA FISHER
Title or Position: OWNER
Credential: LMSW
Phone: 616-890-2174