Provider Demographics
NPI:1861361982
Name:LABYRINTH COUNSELING PROJECT
Entity type:Organization
Organization Name:LABYRINTH COUNSELING PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:TRAVILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MLP
Authorized Official - Phone:616-622-3536
Mailing Address - Street 1:4821 E MEADOWS CT SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8248
Mailing Address - Country:US
Mailing Address - Phone:616-622-3536
Mailing Address - Fax:
Practice Address - Street 1:7150 KALAMAZOO AVE SE STE C
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-9197
Practice Address - Country:US
Practice Address - Phone:616-622-3536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)