Provider Demographics
NPI:1134649981
Name:PLAY IT BY HEART COUNSELING, PC
Entity Type:Organization
Organization Name:PLAY IT BY HEART COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:DEETTE
Authorized Official - Last Name:VAN WYCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:231-329-4262
Mailing Address - Street 1:950 TAYLOR AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2200
Mailing Address - Country:US
Mailing Address - Phone:231-329-4262
Mailing Address - Fax:888-972-2417
Practice Address - Street 1:950 TAYLOR AVE STE 260
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2200
Practice Address - Country:US
Practice Address - Phone:231-329-4262
Practice Address - Fax:888-972-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013905101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty