Individual
MATTHEW SCOTT PETTINGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 365-8920
(616) 365-8971
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401015324
MI
Other
Enumeration date
12/05/2017
Last updated
10/03/2025
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