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General NPI Number Information
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NPI Number | 1790663078
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Entity Type | Organization
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Legal Business Name | MENUEZ HOLISTIC COUNSELING
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1400 LEONARD ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-5515
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Country | US
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Telephone | 616-217-9964
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Fax |
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Provider Business Mailing Address
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Address Line | 2436 SANTA MONICA DR SE
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City | EAST GRAND RAPIDS
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State | MI
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Zip | 49506-3548
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Country | US
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Telephone | 616-217-9964
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CATHY GALLEGOS
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Credential | LPC
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Telephone | 517-204-1270
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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 |
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License Number State |
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