Provider Demographics
NPI:1790024834
Name:HEARTWOOD COUNSELING LLC
Entity Type:Organization
Organization Name:HEARTWOOD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEUWSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-920-0245
Mailing Address - Street 1:518 HOUSEMAN AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-1828
Mailing Address - Country:US
Mailing Address - Phone:616-920-0245
Mailing Address - Fax:
Practice Address - Street 1:2730 ASHVILLE DR NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-3002
Practice Address - Country:US
Practice Address - Phone:616-920-0245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-09
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010864131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty