Provider Demographics
NPI:1417712985
Name:ELEVATED WELLLNESS COUNSELING LLC
Entity Type:Organization
Organization Name:ELEVATED WELLLNESS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOUWKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-844-8038
Mailing Address - Street 1:100 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:COOPERSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49404-1227
Mailing Address - Country:US
Mailing Address - Phone:616-844-8038
Mailing Address - Fax:
Practice Address - Street 1:221 W WEBSTER AVE STE 515
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1294
Practice Address - Country:US
Practice Address - Phone:616-844-8038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty