Healthcare Provider Details

I. General information

NPI: 1447926720
Provider Name (Legal Business Name): LIVING WITH INTENTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 INDIAN TRL
MUNITH MI
49259-9763
US

IV. Provider business mailing address

11586 BUNKERHILL RD # 192
PLEASANT LAKE MI
49272-9786
US

V. Phone/Fax

Practice location:
  • Phone: 517-581-3184
  • Fax:
Mailing address:
  • Phone: 517-518-3184
  • 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: MS. LINDA AR
Title or Position: PROVIDER
Credential: LMSW
Phone: 517-581-3184