MEDICARE: MS. ALETTA E VANDERPLAAT M.A, LPC

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	6401000155	MI

General Provider Information

NPI Number	:	1811037567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALETTA E VANDERPLAAT M.A, LPC

Provider Business Mailing Address
First Line	:	700 3 MILE RD NW STE 1
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49544-8220
Country	:	US
Telephone Number	:	616-785-2769
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 3 MILE RD NW STE 1
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49544-8220
Country	:	US
Telephone Number	:	616-785-2769
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	08/28/2012

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