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General NPI Number Information
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NPI Number | 1134028251
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Entity Type | Organization
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Legal Business Name | HEALTH FOR LIFE COUNSELING
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 781 KENMOOR AVE SE STE C
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-8624
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Country | US
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Telephone | 616-200-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 781 KENMOOR AVE SE STE C
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-8624
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Country | US
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Telephone | 616-200-4433
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Fax |
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Authorized Official
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Title or Position | LIMITED LICENSE PROFESSIONAL COUNSE
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Name | SEAN REGINALD SHANKIN
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Credential | LLPC
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Telephone | 616-345-0502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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