MEDICARE: DEBORAH WESTRATE 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	6451022032	MI

General Provider Information

NPI Number	:	1952055493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH WESTRATE LPC

Provider Business Mailing Address
First Line	:	1652 SHANGRAI LA DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49508-1449
Country	:	US
Telephone Number	:	616-450-5509
Fax Number	:

Provider Business Practice Location Address
First Line	:	2335 BURTON ST SE STE 130
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-4630
Country	:	US
Telephone Number	:	616-450-5509
Fax Number	:

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

Provider Enumeration Date	:	02/03/2022
Last Update Date	:	04/28/2024

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