Healthcare Provider Details

I. General information

NPI: 1306773304
Provider Name (Legal Business Name): DANDELION COUNSELING AND THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5228 LOVERS LN STE 104
PORTAGE MI
49002-1521
US

IV. Provider business mailing address

8108 PERRY ST
PORTAGE MI
49024-5427
US

V. Phone/Fax

Practice location:
  • Phone: 269-350-3035
  • Fax:
Mailing address:
  • Phone: 269-350-3035
  • 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: DANIELLE SNOW
Title or Position: OWNER/THERAPIST
Credential:
Phone: 269-350-3035