MEDICARE: AW COLLECTIVE 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1639023237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AW COLLECTIVE LLC

Provider Business Mailing Address
First Line	:	3444 RIVINGTON DR
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-7761
Country	:	US
Telephone Number	:	616-777-7115
Fax Number	:

Provider Business Practice Location Address
First Line	:	3444 RIVINGTON DR
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-7761
Country	:	US
Telephone Number	:	616-777-7115
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	AMANDA WALMA
Credential	:	MA LPC
Telephone Number	:	616-777-7115

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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Directions to “AW COLLECTIVE LLC ” Practice Location

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