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General NPI Number Information
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NPI Number | 1811764426
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Entity Type | Organization
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Legal Business Name | IMMACULATE HEART COUNSELING PLLC
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 3755 REMEMBRANCE RD NW STE 3
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City | GRAND RAPIDS
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State | MI
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Zip | 49534-7745
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Country | US
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Telephone | 616-379-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 210 LEYDEN AVE SW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-6129
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Country | US
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Telephone | 301-655-8933
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | MR. WILLIAM EDWARD ROBINSON
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Credential | M.DIV, MA, LPC
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Telephone | 301-655-8933
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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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