Provider Demographics
NPI:1295201200
Name:ASCENT COUNSELING AND PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:ASCENT COUNSELING AND PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LEWIS GINEBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:616-890-3292
Mailing Address - Street 1:495 79TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-7241
Mailing Address - Country:US
Mailing Address - Phone:616-890-3292
Mailing Address - Fax:
Practice Address - Street 1:7920 KIRKLAND CT
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4974
Practice Address - Country:US
Practice Address - Phone:269-381-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty