Provider Demographics
NPI:1164638839
Name:THERAPEUTIC CONCEPTS, LLC
Entity Type:Organization
Organization Name:THERAPEUTIC CONCEPTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECREATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:LINETTE
Authorized Official - Last Name:LYNK
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS
Authorized Official - Phone:313-717-6100
Mailing Address - Street 1:586 BAGLEY ST
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-3361
Mailing Address - Country:US
Mailing Address - Phone:313-790-8421
Mailing Address - Fax:
Practice Address - Street 1:586 BAGLEY ST
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-3361
Practice Address - Country:US
Practice Address - Phone:313-790-8421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI24244174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty