Provider Demographics
NPI:1942730387
Name:THE NURTURING SPACE COUNSELING, PLLC
Entity Type:Organization
Organization Name:THE NURTURING SPACE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-571-0445
Mailing Address - Street 1:316 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4434
Mailing Address - Country:US
Mailing Address - Phone:231-571-0445
Mailing Address - Fax:
Practice Address - Street 1:316 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4434
Practice Address - Country:US
Practice Address - Phone:231-571-0445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)