Healthcare Provider Details

I. General information

NPI: 1154286920
Provider Name (Legal Business Name): LNL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 OAK INDUSTRIAL DR. NE SUITE 216
GRAND RAPIDS MI
49505
US

IV. Provider business mailing address

625 KENMOOR AVE, SUITE 301 90948
GRAND RAPIDS MI
49546
US

V. Phone/Fax

Practice location:
  • Phone: 616-970-8924
  • Fax:
Mailing address:
  • Phone:
  • 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: ELLEN MCKENZIE LAUBACHER
Title or Position: OWNER
Credential:
Phone: 616-970-1050