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General NPI Number Information
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NPI Number | 1467789032
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Entity Type | Individual
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Provider Name | STEVEN KREITZER LLPC
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Gender | Male
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 250 MONROE AVE NW SUITE 400
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2211
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Country | US
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Telephone | 616-558-6525
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Fax |
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Provider Business Mailing Address
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Address Line | 715 3 MILE RD NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-3348
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Country | US
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Telephone | 616-558-6525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6401011650
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License Number State | MI
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