Organization Active NPI

Lifework Family & Trauma Counseling PC

  • Mental Health Counselor
  • Birmingham, MI
National Provider Identifier
1205028008
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401003903 Issued in MI
Legal business name
LIFEWORK FAMILY & TRAUMA COUNSELING PC
Practice address
725 S Adams Rd
Suite L 136
Birmingham, MI 48009-6902
Phone
(248) 283-1107
Fax
(248) 723-6646
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kevin J Clouthier, LPC
Title
President
Phone
(248) 283-1107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 6401003903 MI Primary

Addresses

Primary practice location

725 S Adams Rd
Suite L 136
Birmingham, MI 48009-6902

Mailing address

725 S Adams Rd
Suite L 136
Birmingham, MI 48009-6902
Phone (248) 283-1107

Other identifiers 1

IdentifierTypeStateIssuer
A878123OtherMIVALUE OPTIONS

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187136000000",
    "number": "1205028008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S ADAMS RD",
            "address_2": "SUITE L 136",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096902",
            "telephone_number": "248-283-1107",
            "fax_number": "248-723-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S ADAMS RD",
            "address_2": "SUITE L 136",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096902",
            "telephone_number": "248-283-1107",
            "fax_number": "248-723-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORK FAMILY & TRAUMA COUNSELING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A",
        "authorized_official_last_name": "CLOUTHIER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-283-1107",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401003903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "A878123",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.