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General NPI Number Information
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NPI Number | 1518341197
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Entity Type | Organization
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Legal Business Name | LIVE WELL COUNSELING LLC
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 1010 S GARFIELD AVE STE 203
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-3465
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Country | US
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Telephone | 231-714-0685
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 S GARFIELD AVE STE 203
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-3465
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Country | US
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Telephone | 231-714-0685
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | RUTH SPALDING
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Credential | MSW, LMSW
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Telephone | 231-714-0685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | MI
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