Organization
SISU COUNSELING AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA R MILLER LPC (PROFESSIONAL COUNSELOR)
(989) 313-1620
Entity
Organization
Contact information
Practice address
800 MONROE AVE NW, GRAND RAPIDS, MI 49503-1445
(989) 313-1620
Mailing address
2110 MONROE AVE NW, GRAND RAPIDS, MI 49505-4046
(989) 313-1620
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/04/2021
Last updated
08/04/2025
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