MEDICARE: CLEARER VIEW COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1356962658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARER VIEW COUNSELING LLC

Provider Business Mailing Address
First Line	:	1345 MONROE AVE NW STE 323
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-4674
Country	:	US
Telephone Number	:	616-648-4407
Fax Number	:	616-608-4657

Provider Business Practice Location Address
First Line	:	1345 MONROE AVE NW STE 323
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-4674
Country	:	US
Telephone Number	:	616-648-4407
Fax Number	:	616-608-4657

Authorized Official
Title or Position	:	PROVIDER
Name	:	NICOLE M KOTCHKA
Credential	:	LMSW,CAADC
Telephone Number	:	616-648-4407

Provider Enumeration Date	:	04/28/2020
Last Update Date	:	03/19/2024

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