Provider Demographics
NPI:1023537495
Name:TREE OF LIFE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:TREE OF LIFE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-894-2246
Mailing Address - Street 1:1460 WALTON BLVD STE 60
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1729
Mailing Address - Country:US
Mailing Address - Phone:248-608-4514
Mailing Address - Fax:248-608-4519
Practice Address - Street 1:145 ROCHDALE DR S STE F
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-2275
Practice Address - Country:US
Practice Address - Phone:248-608-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-16
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014860101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty