Provider Demographics
NPI:1578966743
Name:VANDENBOSCH COUNSELING SERVICES PLC
Entity Type:Organization
Organization Name:VANDENBOSCH COUNSELING SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNELLENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-935-0747
Mailing Address - Street 1:41 WASHINGTON AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-3318
Mailing Address - Country:US
Mailing Address - Phone:231-670-7631
Mailing Address - Fax:616-607-2006
Practice Address - Street 1:41 WASHINGTON AVE STE 380
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-3318
Practice Address - Country:US
Practice Address - Phone:231-670-7631
Practice Address - Fax:616-607-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010934841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty