Provider Demographics
NPI:1780057711
Name:LIFE BALANCE COUNSELING OF MICHIGAN, LLC
Entity type:Organization
Organization Name:LIFE BALANCE COUNSELING OF MICHIGAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:VANDERZANDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-274-4978
Mailing Address - Street 1:27620 FARMINGTON RD STE B1
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3367
Mailing Address - Country:US
Mailing Address - Phone:248-274-4978
Mailing Address - Fax:248-671-0556
Practice Address - Street 1:27620 FARMINGTON RD STE B1
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3367
Practice Address - Country:US
Practice Address - Phone:248-274-4978
Practice Address - Fax:248-671-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009804101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty