MEDICARE: AWAKENINGS FAMILY THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6802034561	MI

General Provider Information

NPI Number	:	1417058983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AWAKENINGS FAMILY THERAPY LLC

Provider Business Mailing Address
First Line	:	PO BOX 10
Second Line	:
City	:	MASON
State	:	MI
Zip	:	48854-0010
Country	:	US
Telephone Number	:	517-676-9788
Fax Number	:	517-676-3438

Provider Business Practice Location Address
First Line	:	2385 CEDAR PARK DR APT 323
Second Line	:
City	:	HOLT
State	:	MI
Zip	:	48842-3112
Country	:	US
Telephone Number	:	517-331-1433
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	MARYBETH HOUPT
Credential	:
Telephone Number	:	517-676-9788

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	09/22/2020

Similar Medicare Providers

1992806467 — LAURIE S SNYMAN ACSW
Practice Location Address:

2385 CEDAR PARK DR APT 323
HOLT, MI
48842-3112

Practice Phone: 517-331-1433
Practice Fax:

1275193096 — AMANDA PAULSON LMSW, MHP, CMHP
Practice Location Address:

2703 DELLRIDGE DR
HOLT, MI
48842-9718

Practice Phone: 810-938-9931
Practice Fax:

1265374433 — BOLD HORIZONS THERAPY LLC
Practice Location Address:

2703 DELLRIDGE DR
HOLT, MI
48842-9718

Practice Phone: 810-938-9931
Practice Fax:

1023951696 — RONISHA CLARK
Practice Location Address:

2240 CEDAR ST
HOLT, MI
48842-1201

Practice Phone: 517-694-1994
Practice Fax:

1982605739 — MR. WILLIAM A CLARK PA-C
Practice Location Address:

2380 CEDAR ST
HOLT, MI
48842-2143

Practice Phone: 517-742-4922
Practice Fax: 517-699-2904

1467449793 — DR. BRIAN JAMES HOUSER O.D.
Practice Location Address:

1995 CEDAR ST , STE. 1
HOLT, MI
48842-6630

Practice Phone: 517-699-3937
Practice Fax: 517-699-4199

Directions to “AWAKENINGS FAMILY THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.