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General NPI Number Information
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NPI Number | 1518486844
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Entity Type | Organization
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Legal Business Name | KOHLEY COUNSELING LLC
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Dates
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Enumeration Date | 09/19/2017
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Last Update Date | 09/19/2017
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Provider Practice Location Address
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Address Line | 2976 IVANREST AVE SW STE 205
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City | GRANDVILLE
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State | MI
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Zip | 49418-1440
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Country | US
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Telephone | 616-261-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 2723 PARKSIDE DR
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City | JENISON
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State | MI
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Zip | 49428-9102
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Country | US
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Telephone | 616-669-4866
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Fax | 616-669-4866
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH KOHLEY
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Credential | LMSW
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Telephone | 616-261-0888
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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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