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General NPI Number Information
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NPI Number | 1790529055
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Entity Type | Organization
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Legal Business Name | BAY HARBOR COUNSELING PLLC
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 625 KENMOOR AVE SE STE 113487
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2395
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Country | US
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Telephone | 892-257-6529
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Fax |
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Provider Business Mailing Address
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Address Line | 625 KENMOOR AVE SE STE 113487
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2395
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Country | US
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Telephone | 989-402-4640
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATIE BOVEE
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Credential | LMSW
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Telephone | 989-402-4640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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