# HEATHER NITZKI LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** IMPRESSION PSYCHOTHERAPY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417648908
- **Authorized official:** HEATHER NITZKI (PROVIDER)
- **Authorized official phone:** (331) 625-3796

## Contact information

- **Practice address:** 5060 CASCADE RD SE STE D, GRAND RAPIDS, MI 49546-3808
- **Practice address phone:** (331) 625-3796
- **Mailing address:** 5060 CASCADE RD SE STE D, GRAND RAPIDS, MI 49546-3808
- **Mailing address phone:** (331) 625-3796

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2023
- **Last updated:** 05/16/2023