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General NPI Number Information
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NPI Number | 1932825981
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Entity Type | Organization
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Legal Business Name | HAWTHORN HIVE LLC
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1212 VETERANS DR STE 206
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-4734
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Country | US
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Telephone | 231-590-8650
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Fax | 231-642-9101
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Provider Business Mailing Address
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Address Line | PO BOX 6463
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City | TRAVERSE CITY
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State | MI
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Zip | 49696-6463
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Country | US
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Telephone | 231-590-8650
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Fax | 231-642-9101
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Authorized Official
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Title or Position | OWNER - SOLE PROPRIETOR LLC
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Name | KARI LYN DE BOER
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Credential | LPC, ATR, RYT
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Telephone | 231-590-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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