Provider Demographics
NPI:1285459438
Name:CASCADE COUNSELING & RECOVERY LLC
Entity type:Organization
Organization Name:CASCADE COUNSELING & RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBURN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:616-329-0937
Mailing Address - Street 1:7716 CASCADE PNES SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-9173
Mailing Address - Country:US
Mailing Address - Phone:616-329-0937
Mailing Address - Fax:
Practice Address - Street 1:4081 CASCADE RD SE STE 500
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2154
Practice Address - Country:US
Practice Address - Phone:616-379-9690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)