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General NPI Number Information
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NPI Number | 1154085249
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Entity Type | Organization
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Legal Business Name | RIDGE & SWALE COUNSELING LLC
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 1200 W 11TH ST STE 214
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-3289
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Country | US
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Telephone | 269-599-2250
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Fax |
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Provider Business Mailing Address
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Address Line | 1046 S SOUTH LONG LAKE RD
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City | INTERLOCHEN
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State | MI
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Zip | 49643-9714
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Country | US
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Telephone | 269-599-2250
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | HEATHER L HOFFMAN
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Credential | MA, LPC, NCC, CAADC
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Telephone | 269-599-2250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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