Life Transitions Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704199416 Issued in MI

Legal business name

LIFE TRANSITIONS SERVICES LLC

Practice address

21031 Sunnydale St
Saint Clair Shores, MI 48081-3143

Phone

(586) 663-8906

NPI assigned

Aug 13, 2012

Organization subpart

No

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

Authorized official

Name

David Judd, NP

Title

Owner

Phone

(586) 663-8906

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1467709188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21031 SUNNYDALE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813143",
            "telephone_number": "586-663-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21031 SUNNYDALE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813143",
            "telephone_number": "586-663-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TRANSITIONS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-663-8906",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704199416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4704199416",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.