Organization
MJW COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WIERSMA LPC (OWNER)
(616) 953-0780
Entity
Organization
Contact information
Practice address
564 MARCIA ST SW, WYOMING, MI 49509-4013
(616) 953-0780
Mailing address
564 MARCIA ST SW, WYOMING, MI 49509-4013
(616) 953-0780
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14247885
—
MI
Enumeration date
10/29/2020
Last updated
10/29/2020
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