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NPI Code Detail

MEDICARE: DIVINITY BALANCE LLC

MEDICARE: DIVINITY BALANCE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1235089475
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIVINITY BALANCE LLC
Provider Business Mailing Address
First Line : 1229 POPPY HILL DR
Second Line :
City : OXFORD
State : MI
Zip : 48371-6092
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1229 POPPY HILL DR
Second Line :
City : OXFORD
State : MI
Zip : 48371-6092
Country : US
Telephone Number : 248-469-7776
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : DEVINA SMITH
Credential : LPC
Telephone Number : 248-469-7776
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

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Directions to “DIVINITY BALANCE LLC ” Practice Location

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