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Organization

SUPPRESSION EXPRESSION COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA L SHUMP LPC, CCATP, CMIP (OWNER)
(616) 287-2283
Entity
Organization

Contact information

Practice address
4370 CHICAGO DR SW # 515, GRANDVILLE, MI 49418-1694
(616) 287-2283
Mailing address
4370 CHICAGO DR SW # 515, GRANDVILLE, MI 49418-1694
(616) 287-2283

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor

Other

Enumeration date
02/08/2022
Last updated
07/21/2022
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