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Contact Information

PROMINENT LIFE CHANGES THERAPY GROUP. P.C.
2844 LIVERNOIS ROAD
UNIT 1434
TROY, MI48099
 Phone: 586-942-1430
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for PROMINENT LIFE CHANGES THERAPY GROUP. P.C.

NPI Number 1326707399
LBN Legal business name PROMINENT LIFE CHANGES THERAPY GROUP. P.C.
Authorized official WENDY VAUGHTER - (CLINICAL SOCIAL WORKER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/16/2021
Last updated 02/26/2024 - About 2 years ago
Identifiers
MI Medicaid 1417419318
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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