Provider Demographics
NPI:1346939667
Name:HEARTWORK COUNSELING & WELLNESS LLC
Entity Type:Organization
Organization Name:HEARTWORK COUNSELING & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-631-4628
Mailing Address - Street 1:2025 COLLEGE AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-3101
Mailing Address - Country:US
Mailing Address - Phone:231-631-4628
Mailing Address - Fax:
Practice Address - Street 1:1680 E PARIS AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8809
Practice Address - Country:US
Practice Address - Phone:231-631-4628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty