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General NPI Number Information
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NPI Number | 1235798570
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Entity Type | Organization
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Legal Business Name | AMANDA DEHAAN COUNSELING, LLC
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 1055 GEZON PKWY SW
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City | WYOMING
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State | MI
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Zip | 49509-9542
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Country | US
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Telephone | 616-773-2908
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 MEADOWOOD LN SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-2033
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Country | US
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Telephone | 616-460-1663
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | AMANDA K DEHAAN
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Credential | LMSW
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Telephone | 616-460-1663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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