Individual
AMANDA COLLEY JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CAADC
Contact information
Practice address
800 MONROE AVE NW STE 217, GRAND RAPIDS, MI 49503-1451
(248) 935-5135
Mailing address
4593 CANTERWOOD DR NE, ADA, MI 49301-8712
(248) 935-5135
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401019189
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
MI
101YP2500X
Professional Counselor
Primary
6401019189
MI
Other
Enumeration date
02/12/2019
Last updated
01/23/2026
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