Provider Demographics
NPI:1043394703
Name:NORTHWEST COUNSELING ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:NORTHWEST COUNSELING ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-453-6100
Mailing Address - Street 1:4175 3 MILE RD NW
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534-1133
Mailing Address - Country:US
Mailing Address - Phone:616-453-6100
Mailing Address - Fax:616-453-6157
Practice Address - Street 1:4175 3 MILE RD NW
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49534-1133
Practice Address - Country:US
Practice Address - Phone:616-453-6100
Practice Address - Fax:616-453-6157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI410331OtherOP SUBSTANCE ABUSE