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General NPI Number Information
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NPI Number | 1215395017
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Entity Type | Organization
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Legal Business Name | ORCHARD HILL COUNSELING
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 1465 3 MILE RD NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49544-1614
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Country | US
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Telephone | 616-784-5095
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Fax | 616-784-4410
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Provider Business Mailing Address
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Address Line | 1465 3 MILE RD NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49544-1614
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Country | US
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Telephone | 616-784-5095
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Fax | 616-784-4410
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Authorized Official
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Title or Position | DIRECTOR OF COUNSELING
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Name | AARON VAN MANEN
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Credential | LLPC
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Telephone | 616-784-5095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401014678
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License Number State | MI
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