Provider Demographics
NPI:1346805405
Name:WEST MICHIGAN COUNSELING SERVICES
Entity Type:Organization
Organization Name:WEST MICHIGAN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLP
Authorized Official - Phone:616-560-5954
Mailing Address - Street 1:436 44TH ST SE STE C
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49548-4371
Mailing Address - Country:US
Mailing Address - Phone:616-560-5954
Mailing Address - Fax:616-233-0630
Practice Address - Street 1:436 44TH ST SE STE C
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49548-4371
Practice Address - Country:US
Practice Address - Phone:616-560-5954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-04
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty