| Headwaters Counseling, Llc | |
|
201 W Washington Ave Ste 280 Zeeland MI 49464-1074 | |
| (616) 259-5452 | |
| (616) 236-0875 |
| Full Name | Headwaters Counseling, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 201 W Washington Ave Ste 280, Zeeland, Michigan |
| Authorized Official Name and Position | Keith A Louwerse (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6162595452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Headwaters Counseling, Llc 201 W Washington Ave Ste 280 Zeeland MI 49464-1074 Ph: (616) 259-5452 | Headwaters Counseling, Llc 201 W Washington Ave Ste 280 Zeeland MI 49464-1074 Ph: (616) 259-5452 |
| NPI Number | 1184172272 |
|---|---|
| Provider Enumeration Date | 09/17/2016 |
| Last Update Date | 09/11/2023 |
| Certification Date | 09/11/2023 |
| Medicare PECOS PAC ID | 8123374667 |
|---|---|
| Medicare Enrollment ID | O20180713000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184172272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301015112 (Michigan) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Keith A Louwerse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174750459 PECOS PAC ID: 4082800834 Enrollment ID: I20120911000676 |
| Provider Name | Kaitlyn Nicole Gould |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477218923 PECOS PAC ID: 6608234109 Enrollment ID: I20230615000255 |
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