Provider Demographics
NPI:1376300665
Name:POSITIVE ENERGY THERAPY LLC
Entity Type:Organization
Organization Name:POSITIVE ENERGY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-677-4684
Mailing Address - Street 1:203 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49094-1135
Mailing Address - Country:US
Mailing Address - Phone:269-245-6146
Mailing Address - Fax:
Practice Address - Street 1:28 W CHICAGO ST STE 2B
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1678
Practice Address - Country:US
Practice Address - Phone:517-677-4684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty