Individual
GROVER WAYNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA,CSAC,CAC
Contact information
Practice address
5816 W US HIGHWAY 10, LUDINGTON, MI 49431-2494
(231) 843-4899
(231) 843-8929
Mailing address
1095 3RD ST, SUITE 125, MUSKEGON, MI 49441-1976
(231) 726-4735
(231) 722-0789
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712452
—
MI
Enumeration date
01/09/2007
Last updated
09/11/2025
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