Intentional Life Counseling & Addictions Treatment PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INTENTIONAL LIFE COUNSELING & ADDICTIONS TREATMENT PLLC

Practice address

1444 Michigan St NE Ste 3
Grand Rapids, MI 49503-2028

Phone

(616) 734-9745

NPI assigned

Sep 20, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thavone Huinil, MSW

Title

Owner

Phone

(616) 734-9745

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1912416181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 MICHIGAN ST NE STE 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 MICHIGAN ST NE STE 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032028",
            "telephone_number": "616-734-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENTIONAL LIFE COUNSELING & ADDICTIONS TREATMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "HUINIL",
        "authorized_official_first_name": "THAVONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-734-9745",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.