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Organization

AUTHENTICITY RECOVERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTYNE LEE ORTQUIST LPC (CLINICAL DIRECTOR)
(616) 638-7408
Entity
Organization

Contact information

Practice address
4500 CASCADE RD SE STE 102, GRAND RAPIDS, MI 49546-3665
(616) 638-7408
Mailing address
4500 CASCADE RD SE STE 102, GRAND RAPIDS, MI 49546-3665
(616) 638-7408

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
133N00000X
Nutritionist
171400000X
Health & Wellness Coach

Other

Enumeration date
07/30/2025
Last updated
10/25/2025
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