Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Authentic Self Holistic Psychotherapy LLC

Organization Clinical Social Worker · NPI 1316740046

Authentic Self Holistic Psychotherapy LLC is a Clinical Social Worker in Rockford, Michigan. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7989 Myers Lake Ave NE
Rockford, MI 49341-9634
Phone: (616) 498-2566
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1316740046
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Denise Potter — Therapist · (616) 498-2566
NPI enumeratedMarch 28, 2025
Last updated in NPPESMarch 28, 2025
Certification dateMarch 28, 2025
Mailing address7989 Myers Lake Ave Ne, Rockford, MI 49341-9634

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