| Grand Rapids Counseling And Consultation Llc | |
|
1239 76th St Sw Ste H4 Byron Center MI 49315-7921 | |
| (616) 780-1243 | |
| Not Available |
| Full Name | Grand Rapids Counseling And Consultation Llc |
|---|---|
| Speciality | Counselor |
| Location | 1239 76th St Sw Ste H4, Byron Center, Michigan |
| Authorized Official Name and Position | Kelly Ibarra (OWNER) |
| Authorized Official Contact | 6162586270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Rapids Counseling And Consultation Llc 1239 76th St Sw Ste H4 Byron Center MI 49315-7921 Ph: (616) 780-1243 | Grand Rapids Counseling And Consultation Llc 1239 76th St Sw Ste H4 Byron Center MI 49315-7921 Ph: (616) 780-1243 |
| NPI Number | 1205544087 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Medicare PECOS PAC ID | 1658715925 |
|---|---|
| Medicare Enrollment ID | O20240215000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205544087 | NPI | - | NPPES |
| Provider Name | Kelly Lynn Ibarra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063075562 PECOS PAC ID: 2567806839 Enrollment ID: I20240215000977 |
| Provider Name | Amanda Nicole Walma |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043674807 PECOS PAC ID: 1052831047 Enrollment ID: I20250220002463 |
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