Provider Demographics
NPI:1003788142
Name:LAETISSIMA MENTAL HEALTH PLLC
Entity type:Organization
Organization Name:LAETISSIMA MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-915-9559
Mailing Address - Street 1:1150 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:49945-1292
Mailing Address - Country:US
Mailing Address - Phone:989-915-9559
Mailing Address - Fax:
Practice Address - Street 1:212 MISTY WAY
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-8642
Practice Address - Country:US
Practice Address - Phone:989-915-9559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty