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Contact Information

LIFE JOURNEY PLLC
2013 EAST CASTLE DRIVE SW
SUITE B
GRAND RAPIDS, MI49508
 Phone: 616-888-1120
 Fax: 616-469-1113
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Counseling

103TC1900X 62 Psychologist, Clinical
 

Forensic

103TF0200X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
 

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIFE JOURNEY PLLC · (Female)

NPI # 1538531017
Status Active
Credentials
Entity Individual
Enumeration date 10/23/2015
Last updated 01/24/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 6301016514
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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