Provider Demographics
NPI:1477019404
Name:MELISSA MUIR COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:MELISSA MUIR COUNSELING SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-446-8436
Mailing Address - Street 1:630 KENMOOR AVE SE STE 101A
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8626
Mailing Address - Country:US
Mailing Address - Phone:616-446-8436
Mailing Address - Fax:616-920-6536
Practice Address - Street 1:630 KENMOOR AVE SE STE 101A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8626
Practice Address - Country:US
Practice Address - Phone:616-446-8436
Practice Address - Fax:616-920-6536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty