Provider Demographics
NPI:1609235746
Name:HOEKWATER, CHASE MACKENZIE (LLPC)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:MACKENZIE
Last Name:HOEKWATER
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7284 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-8127
Mailing Address - Country:US
Mailing Address - Phone:616-828-2583
Mailing Address - Fax:
Practice Address - Street 1:7284 12TH AVE
Practice Address - Street 2:
Practice Address - City:JENISON
Practice Address - State:MI
Practice Address - Zip Code:49428-8127
Practice Address - Country:US
Practice Address - Phone:616-828-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional