Provider Demographics
NPI:1437610730
Name:COUNSELING CENTER OF WEST MICHIGAN, LLC
Entity Type:Organization
Organization Name:COUNSELING CENTER OF WEST MICHIGAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:TIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LMFT, NCC
Authorized Official - Phone:616-805-3660
Mailing Address - Street 1:333 BRIDGE ST NW STE 1120
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-5356
Mailing Address - Country:US
Mailing Address - Phone:616-805-3660
Mailing Address - Fax:616-805-3631
Practice Address - Street 1:360 E BELTLINE AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1214
Practice Address - Country:US
Practice Address - Phone:616-805-3660
Practice Address - Fax:616-808-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty