Healthcare Provider Details

I. General information

NPI: 1770217853
Provider Name (Legal Business Name): TRANQUIL SOUL COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 CHARLEVOIX RD STE 304
PETOSKEY MI
49770-8423
US

IV. Provider business mailing address

PO BOX 14
WALLOON LAKE MI
49796-0014
US

V. Phone/Fax

Practice location:
  • Phone: 231-486-5434
  • Fax: 877-406-2565
Mailing address:
  • Phone: 231-486-5434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JEAN MOREE
Title or Position: OWNER/COUNSELOR
Credential: M.S., ED.S., LPC
Phone: 231-486-5434