Healthcare Provider Details

I. General information

NPI: 1023989902
Provider Name (Legal Business Name): LIFES PACE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 OAK INDUSTRIAL DR NE STE 209
GRAND RAPIDS MI
49505-6037
US

IV. Provider business mailing address

2215 OAK INDUSTRIAL DR NE STE 209
GRAND RAPIDS MI
49505-6037
US

V. Phone/Fax

Practice location:
  • Phone: 616-288-1556
  • Fax: 616-288-1556
Mailing address:
  • Phone: 616-288-1556
  • Fax: 616-288-1556

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: ROBERT SMITH
Title or Position: PRACTICE OWNER
Credential: LMSW
Phone: 616-288-1556