Healthcare Provider Details

I. General information

NPI: 1669138673
Provider Name (Legal Business Name): VALARIE JAMES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2021
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 44TH ST SW
WYOMING MI
49519-4276
US

IV. Provider business mailing address

2301 WILSON AVE SW
GRAND RAPIDS MI
49534-6501
US

V. Phone/Fax

Practice location:
  • Phone: 616-389-0788
  • Fax: 616-317-4933
Mailing address:
  • Phone: 616-206-7255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VALARIE S JAMES
Title or Position: OWNER
Credential: LMSW
Phone: 616-206-7255