Healthcare Provider Details

I. General information

NPI: 1902743792
Provider Name (Legal Business Name): TREE OF LIFE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 WADSWORTH RD
WADSWORTH OH
44281-9503
US

IV. Provider business mailing address

140 WADSWORTH RD
WADSWORTH OH
44281-9503
US

V. Phone/Fax

Practice location:
  • Phone: 330-812-9888
  • Fax: 330-334-2235
Mailing address:
  • Phone: 330-812-9888
  • Fax: 330-334-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE A WATKINS-MALEK
Title or Position: PROVIDER
Credential: MA, LPCC
Phone: 330-812-9888