Provider Demographics
NPI:1619794401
Name:INTENTIONAL SOLUTIONS LIFE COACHING & CONSULTING LLC
Entity type:Organization
Organization Name:INTENTIONAL SOLUTIONS LIFE COACHING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:MARCEL
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LMSW
Authorized Official - Phone:989-482-5351
Mailing Address - Street 1:32481 THORNCASTLE DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-2356
Mailing Address - Country:US
Mailing Address - Phone:989-482-5351
Mailing Address - Fax:
Practice Address - Street 1:32481 THORNCASTLE DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-2356
Practice Address - Country:US
Practice Address - Phone:989-482-5351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty