Individual
MR. MIKE JAY PONTIUS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 988-9388
(616) 732-6392
Mailing address
PO BOX 150521, GRAND RAPIDS, MI 49515-0521
(616) 437-6628
(616) 336-2166
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401006132
MI
1041C0700X
Clinical Social Worker
6801062098
MI
Other
Enumeration date
11/17/2006
Last updated
09/11/2025
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