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General NPI Number Information
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NPI Number | 1306632757
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Entity Type | Organization
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Legal Business Name | RECHARGE COUNSELING LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 1651 W CENTRE AVE STE 208
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City | PORTAGE
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State | MI
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Zip | 49024-6312
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Country | US
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Telephone | 616-379-9772
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 HARPER GROVE LN
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City | VICKSBURG
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State | MI
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Zip | 49097-7774
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DALLAS KROLL
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Credential |
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Telephone | 616-379-9772
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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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