NPIMap

Organization Active NPI

Life's Work Clinic, PLLC

  • Adult Mental Health Clinic/Center
  • Kalkaska, MI
National Provider Identifier
1275189490
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
LIFE'S WORK CLINIC, PLLC
Practice address
103 W 3Rd St Unit E
Kalkaska, MI 49646-5107
Phone
(231) 620-7977
Fax
(231) 715-3222
NPI assigned
Aug 13, 2019
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Adam Devaney, CLINICAL SOCIAL WORKNPI 1043755135
Title
Owner
Phone
(231) 620-7977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

103 W 3Rd St Unit E
Kalkaska, MI 49646-5107

Mailing address

103 W 3Rd St. Unit E - 524
Kalkaska, MI 49646-0524
Phone (231) 620-7977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201130000216 MI Part B Supplier - Clinic/Group Practice 4981015716 Receives reassigned benefits from 3 practitioners
Practice locations: Kalkaska, MI

National Provider Directory

National Provider Directory

Locations

733 E Eighth St
Ste 107
Traverse City, MI 49686

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1275189490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W 3RD ST. UNIT E - 524",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496460524",
            "telephone_number": "231-620-7977",
            "fax_number": "231-715-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W 3RD ST UNIT E",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496465107",
            "telephone_number": "231-620-7977",
            "fax_number": "231-715-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE'S WORK CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "DEVANEY",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-620-7977",
        "authorized_official_credential": "CLINICAL SOCIAL WORK"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalkaska, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.