Provider Demographics
NPI:1528806437
Name:COMPASSIONATE COUCH THERAPY
Entity type:Organization
Organization Name:COMPASSIONATE COUCH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:LLP, LPC
Authorized Official - Phone:616-227-0806
Mailing Address - Street 1:2050 BRETON RD SE STE 104
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-5547
Mailing Address - Country:US
Mailing Address - Phone:616-227-0806
Mailing Address - Fax:616-226-4621
Practice Address - Street 1:2050 BRETON RD SE STE 104
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5547
Practice Address - Country:US
Practice Address - Phone:616-227-0806
Practice Address - Fax:616-226-4621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty