Provider Demographics
NPI:1588464366
Name:NEWAYGO COUNTY COUNSELING, PLLC
Entity type:Organization
Organization Name:NEWAYGO COUNTY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RAQUET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:616-279-9825
Mailing Address - Street 1:1801 CORNER ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-9405
Mailing Address - Country:US
Mailing Address - Phone:616-279-9825
Mailing Address - Fax:
Practice Address - Street 1:4040 W 72ND ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-9254
Practice Address - Country:US
Practice Address - Phone:231-924-5309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)