Healthcare Provider Details

I. General information

NPI: 1215864301
Provider Name (Legal Business Name): NORTHERN LIGHTS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5956 NN RD
GARDEN MI
49835-9477
US

IV. Provider business mailing address

5956 NN RD
GARDEN MI
49835-9477
US

V. Phone/Fax

Practice location:
  • Phone: 906-553-2526
  • Fax:
Mailing address:
  • Phone: 906-553-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMY PLETTNER
Title or Position: THERAPIST
Credential: LMSW
Phone: 906-553-2526