Provider Demographics
NPI:1093379208
Name:TRANQUILITY COUNSELING PLLC
Entity Type:Organization
Organization Name:TRANQUILITY COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SQUETERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-396-5284
Mailing Address - Street 1:1345 MONROE AVE NW STE 234
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-4692
Mailing Address - Country:US
Mailing Address - Phone:616-308-8754
Mailing Address - Fax:
Practice Address - Street 1:1345 MONROE AVE NW STE 234
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-4692
Practice Address - Country:US
Practice Address - Phone:616-308-8754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty