Organization Active NPI

Lifes Changes Center for Wellness

  • Clinic/Center
  • Flint, MI
National Provider Identifier
1558096701
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFES CHANGES CENTER FOR WELLNESS
Practice address
2425 S Linden Rd Ste D105
Flint, MI 48532-5457
Phone
(810) 252-7994
NPI assigned
Jul 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Authorized official

Name
Charles T. Kennedy Jr., LMSWNPI 1467824425
Title
Clinical Director
Phone
(810) 252-7994

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2425 S Linden Rd Ste D105
Flint, MI 48532-5457

Mailing address

6120 Sierra Pass
Flint, MI 48532-2134
Phone (810) 252-7994

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220929002934 MI Part B Supplier - Clinic/Group Practice 8224414123 Receives reassigned benefits from 1 practitioner
Practice locations: Flint, MI

National Provider Directory

National Provider Directory

Locations

2425 S Linden Rd
Ste D105
Flint, MI 48532
Phone (810) 252-7994

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1558096701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 SIERRA PASS",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485322134",
            "telephone_number": "810-252-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 S LINDEN RD STE D105",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485325457",
            "telephone_number": "810-252-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFES CHANGES CENTER FOR WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-21",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "810-252-7994",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.