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General NPI Number Information
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NPI Number | 1558246280
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Entity Type | Organization
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Legal Business Name | RELATIONAL THERAPY COLLECTIVE LLC
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 146 MONROE CENTER ST NW STE 1104
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2820
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Country | US
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Telephone | 616-626-1082
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 COLLEGE AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49507-2621
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Country | US
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Telephone | 616-209-8854
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACOB MOON
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Credential | LMFT, LPC
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Telephone | 616-209-8854
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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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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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