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General NPI Number Information
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NPI Number | 1386081750
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Entity Type | Organization
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Legal Business Name | WITTEVEEN COUNSELING, LLC
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Dates
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Enumeration Date | 05/26/2013
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 300 S STATE ST STE 13
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City | ZEELAND
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State | MI
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Zip | 49464-1676
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Country | US
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Telephone | 616-772-1733
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Fax |
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Provider Business Mailing Address
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Address Line | 10427 NORTHFIELD DR
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City | ZEELAND
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State | MI
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Zip | 49464-6846
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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 | COUNSELOR
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Name | MRS. STEPHANIE WITTEVEEN
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Credential | MA, LPC
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Telephone | 616-566-1365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401013655
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License Number State | MI
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