Healthcare Provider Details

I. General information

NPI: 1619755485
Provider Name (Legal Business Name): MAKING MEANING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 01/13/2025
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 TIBBETS LAKE LN
TRAVERSE CITY MI
49696
US

IV. Provider business mailing address

801 S GARFIELD AVE # 131
TRAVERSE CITY MI
49686-3429
US

V. Phone/Fax

Practice location:
  • Phone: 813-825-0885
  • Fax:
Mailing address:
  • Phone: 813-825-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KEVIN MCDOWELL
Title or Position: OWNER
Credential: PSYD
Phone: 813-825-0885