Healthcare Provider Details

I. General information

NPI: 1023833944
Provider Name (Legal Business Name): OPTIMAL COUNSELING OF SOUTHWEST MICHIGAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12020 COON HOLLOW RD
THREE RIVERS MI
49093-9517
US

IV. Provider business mailing address

12020 COON HOLLOW RD
THREE RIVERS MI
49093-9517
US

V. Phone/Fax

Practice location:
  • Phone: 269-506-8744
  • Fax:
Mailing address:
  • Phone: 269-506-8744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. WENDY M LUDWIG
Title or Position: COUNSELOR/OWNER
Credential: LPC
Phone: 269-506-8744