| Tranquil Life Counseling Llc | |
|
275 S State Rd Otisville MI 48463-8436 | |
| (810) 374-6115 | |
| Not Available |
| Full Name | Tranquil Life Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 275 S State Rd, Otisville, Michigan |
| Authorized Official Name and Position | Amanda Renee Southern (OWNER) |
| Authorized Official Contact | 8109227700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tranquil Life Counseling Llc 275 S State Rd Otisville MI 48463-8436 Ph: (810) 374-6115 | Tranquil Life Counseling Llc 275 S State Rd Otisville MI 48463-8436 Ph: (810) 374-6115 |
| NPI Number | 1851958151 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 06/13/2022 |
| Certification Date | 06/13/2022 |
| Medicare PECOS PAC ID | 7618355256 |
|---|---|
| Medicare Enrollment ID | O20220609001950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851958151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Amanda R Southern |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982945549 PECOS PAC ID: 6709194913 Enrollment ID: I20151007001252 |
| Provider Name | Keri A Kennedy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700051836 PECOS PAC ID: 5092066191 Enrollment ID: I20181001000583 |
| Provider Name | Tanya Roe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164852430 PECOS PAC ID: 6901279611 Enrollment ID: I20230228001844 |
| Provider Name | Kimberly Redmond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952750044 PECOS PAC ID: 7012377864 Enrollment ID: I20230712002557 |