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General NPI Number Information
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NPI Number | 1326560723
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Entity Type | Organization
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Legal Business Name | LIFE TRANSITIONS THERAPY LLC
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 131 S CENTER ST
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City | LOWELL
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State | MI
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Zip | 49331-1501
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Country | US
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Telephone | 616-238-2116
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Fax |
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Provider Business Mailing Address
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Address Line | 131 S CENTER ST
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City | LOWELL
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State | MI
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Zip | 49331-1501
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Country | US
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Telephone | 616-238-2116
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Fax |
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Authorized Official
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Title or Position | OWNER - MENTAL HEALTH THERAPIST
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Name | MELISSA SPINO
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Credential | MA LLPC CDMS
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Telephone | 616-238-2116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 6401010798
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License Number State | MI
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