Provider Demographics
NPI:1407088198
Name:POSITIVE LIVING CONSULTANTS INC.
Entity Type:Organization
Organization Name:POSITIVE LIVING CONSULTANTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-559-7152
Mailing Address - Street 1:16930 NEW HAMPSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2905
Mailing Address - Country:US
Mailing Address - Phone:248-559-7152
Mailing Address - Fax:248-559-5101
Practice Address - Street 1:16930 NEW HAMPSHIRE DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2905
Practice Address - Country:US
Practice Address - Phone:248-559-7152
Practice Address - Fax:248-559-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401000019101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty