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Individual

ADAM RICHARD SHANTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
41 WASHINGTON AVE STE 308, GRAND HAVEN, MI 49417-1587
(616) 414-4962
(616) 344-2131
Mailing address
1524 SLAYTON AVE, GRAND HAVEN, MI 49417-2039
(616) 402-4502

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401222574
MI
101Y00000X
Counselor

Other

Enumeration date
03/06/2018
Last updated
10/29/2024
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