Individual
CRAIG BOLTHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLMSW
Contact information
Practice address
6070 NEWPORT RD, PORTAGE, MI 49002-9234
(269) 409-3000
Mailing address
707 MYRTLE ST, STURGIS, MI 49091-2231
(269) 908-3646
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6851120030APP25
MI
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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