Organization
NEW REVELATION COUNSELING SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ROBERT RICHMAN LPC (OWNER/LICENSED COUNSELOR)
(616) 888-4353
Entity
Organization
Contact information
Practice address
975 SPAULDING AVE SE STE D, ADA, MI 49301-3776
(616) 888-4353
Mailing address
1658 DIAMOND CT NE, GRAND RAPIDS, MI 49505-4869
(616) 888-4353
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609292333
—
MI
Enumeration date
04/03/2019
Last updated
04/03/2019
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