Organization Active NPI

Real Life Counseling of Northern Michigan

  • Professional Counselor
  • Petoskey, MI
National Provider Identifier
1396585840
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
REAL LIFE COUNSELING OF NORTHERN MICHIGAN
Practice address
1982 E. Mitchell Rd.
Petoskey, MI 49770
Phone
(231) 622-5800
Fax
(231) 272-5721
NPI assigned
May 30, 2024
Last updated
Nov 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Authorized official

Name
Jake Tracy
Title
Counselor
Phone
(231) 622-5800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

1982 E. Mitchell Rd.
Petoskey, MI 49770

Mailing address

1982 E. Mitchell Rd.
Petoskey, MI 49770
Phone (231) 622-5800

National Provider Directory

National Provider Directory

Locations

1982 E Mitchell Rd
Petoskey, MI 49770
Phone (231) 347-6058

410 E Lake St
Ste 100
Petoskey, MI 49770
Phone (231) 753-8055

Practitioners & affiliated clinicians

Practitioners 3

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": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763942400000",
    "number": "1396585840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1982 E. MITCHELL RD.",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-622-5800",
            "fax_number": "231-272-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 E. MITCHELL RD.",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-622-5800",
            "fax_number": "231-272-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL LIFE COUNSELING OF NORTHERN MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "231-622-5800"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.