Provider Demographics
NPI:1023625068
Name:WHOLEHEARTED COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:WHOLEHEARTED COUNSELING SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LMSW
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BLAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-644-2835
Mailing Address - Street 1:1248 DIVOT DR NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-2470
Mailing Address - Country:US
Mailing Address - Phone:616-644-2835
Mailing Address - Fax:
Practice Address - Street 1:800 MONROE AVE NW STE 206
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1448
Practice Address - Country:US
Practice Address - Phone:616-644-2835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty