Provider Demographics
NPI:1336727676
Name:PEACE LOVE COUNSELING, LLC
Entity Type:Organization
Organization Name:PEACE LOVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-252-0929
Mailing Address - Street 1:5029 CANAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49418-9722
Mailing Address - Country:US
Mailing Address - Phone:810-252-0929
Mailing Address - Fax:
Practice Address - Street 1:3282 CLEAR VISTA CT NE STE B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9766
Practice Address - Country:US
Practice Address - Phone:616-286-1905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)