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Individual

MRS. SARAH E.W. KOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC, LCAC, LPC

Contact information

Practice address
805 LEONARD ST NE, GRAND RAPIDS, MI 49503-1138
(616) 451-2021
Mailing address
105 ROLLINGROCK DR, ROCKFORD, MI 49341-1197
(517) 448-0228

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3072-A
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001563A
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
A9927
NC
101YP2500X
Professional Counselor
A9927
NC
103TC1900X
Counseling Psychologist
Primary
6401016578
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000000
MI
Enumeration date
10/04/2012
Last updated
06/15/2020
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