Provider Demographics
NPI:1902264088
Name:UNTANGLED COUNSELING, PLLC
Entity type:Organization
Organization Name:UNTANGLED COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALK
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW
Authorized Official - Phone:616-886-0820
Mailing Address - Street 1:440 S STATE ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-2060
Mailing Address - Country:US
Mailing Address - Phone:616-990-8544
Mailing Address - Fax:
Practice Address - Street 1:440 S STATE ST
Practice Address - Street 2:SUITE 320
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-2060
Practice Address - Country:US
Practice Address - Phone:616-990-8544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801088501251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health