Provider Demographics
NPI:1982404695
Name:CULTIVATE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:CULTIVATE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-376-0774
Mailing Address - Street 1:4703 34TH ST
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-9205
Mailing Address - Country:US
Mailing Address - Phone:517-376-0774
Mailing Address - Fax:
Practice Address - Street 1:4301 CANAL AVE SW STE I
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2667
Practice Address - Country:US
Practice Address - Phone:517-376-0774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty