=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437009503
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTERED COUNSELING & COACHING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2026
-----------------------------------------------------
Last Update Date | 01/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2610 RAYMOND AVE SE
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49507-3930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-570-3355
-----------------------------------------------------
Fax | 517-323-9531
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2610 RAYMOND AVE SE
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49507-3930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-570-3355
-----------------------------------------------------
Fax | 517-323-9531
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALING MANAGER
-----------------------------------------------------
Name | CATHRYN GALLEGOS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 517-483-2461
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------