Provider Demographics
NPI:1457933889
Name:TREE OF LIFE COUNSELING AND WELLNESS, LLC
Entity Type:Organization
Organization Name:TREE OF LIFE COUNSELING AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:269-248-7531
Mailing Address - Street 1:31816 M 152
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-8944
Mailing Address - Country:US
Mailing Address - Phone:269-635-3634
Mailing Address - Fax:
Practice Address - Street 1:703 N STATE ST
Practice Address - Street 2:
Practice Address - City:GOBLES
Practice Address - State:MI
Practice Address - Zip Code:49055-9408
Practice Address - Country:US
Practice Address - Phone:269-248-7531
Practice Address - Fax:269-210-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty