Healthcare Provider Details

I. General information

NPI: 1396363933
Provider Name (Legal Business Name): PARENTS ZONE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 W SAGINAW HIGHWAY SUITE 9
LANSING MI
48917
US

IV. Provider business mailing address

1030 BURLINGTON LN STE 5
FRANKFORT KY
40601-8444
US

V. Phone/Fax

Practice location:
  • Phone: 502-276-5096
  • Fax:
Mailing address:
  • Phone: 502-276-5096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DARLENE MARIE DAVIS GOODWINE
Title or Position: CLINICAL PSYCHOLOGITS
Credential: LP, LCADC, CAADC
Phone: 22-765-0965