Provider Demographics
NPI:1538658851
Name:HUFFER, JON AUSTIN
Entity type:Individual
Prefix:
First Name:JON
Middle Name:AUSTIN
Last Name:HUFFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AUSTIN
Other - Middle Name:
Other - Last Name:HUFFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:201 W WASHINGTON AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1074
Mailing Address - Country:US
Mailing Address - Phone:616-259-5452
Mailing Address - Fax:
Practice Address - Street 1:201 W WASHINGTON AVE STE 280
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1074
Practice Address - Country:US
Practice Address - Phone:616-259-5452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223970101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional