Individual
SARAH KRUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
926 WASHINGTON AVE, HOLLAND, MI 49423-7725
(616) 820-3780
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401013793
MI
101YM0800X
Mental Health Counselor
6401013793
MI
101YP2500X
Professional Counselor
Primary
6401013793
MI
103T00000X
Psychologist
6301015626
MI
Other
Enumeration date
08/12/2013
Last updated
12/14/2023
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