Organization Name: | GRACE HAVEN COUNSELING, LLC |
NPI Number: | 1063893907 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORI LEE VANHARMELEN (CLINICAL SOCIAL WORKER) |
Mailing Address: | 4565 Wilson Ave Sw Ste. 4a Grandville |
State: | MI US |
Postal Code: | 494182371 |
Phone Number: | 6167452387 |
Fax Number: | 6164323059 |
NPI Enumeration Date: | 06/16/2015 |
NPI Last Update Date: | 06/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801090152 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |