Provider Demographics
NPI:1699016188
Name:COUNSELING ASSOCIATES OF WEST MICHIGAN LLC
Entity Type:Organization
Organization Name:COUNSELING ASSOCIATES OF WEST MICHIGAN LLC
Other - Org Name:MARY LIER LMSW, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:LIER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW
Authorized Official - Phone:616-264-3200
Mailing Address - Street 1:4127 EMBASSY DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2418
Mailing Address - Country:US
Mailing Address - Phone:616-264-3200
Mailing Address - Fax:616-264-3201
Practice Address - Street 1:4127 EMBASSY DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2418
Practice Address - Country:US
Practice Address - Phone:616-264-3200
Practice Address - Fax:616-264-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010588151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty