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General NPI Number Information
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NPI Number | 1962288217
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Entity Type | Organization
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Legal Business Name | A BERGSMA COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | 800 MONROE AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1445
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Country | US
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Telephone | 616-232-6772
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Fax |
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Provider Business Mailing Address
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Address Line | 2333 LONGMEADOW ST NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-2317
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Country | US
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Telephone | 616-481-2463
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALYSSA BERGSMA
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Credential | LPC
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Telephone | 616-232-6722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 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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Taxonomy #3
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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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