Provider Demographics
NPI:1710562822
Name:PIVOT COUNSELING, PLLC
Entity Type:Organization
Organization Name:PIVOT COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PENCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:616-422-7820
Mailing Address - Street 1:440 S STATE ST STE 320
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-2250
Mailing Address - Country:US
Mailing Address - Phone:616-422-7820
Mailing Address - Fax:
Practice Address - Street 1:440 S STATE ST STE 320
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-2250
Practice Address - Country:US
Practice Address - Phone:616-422-7820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health