The Center for Intentional Living, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801096404 Issued in MI

Legal business name

THE CENTER FOR INTENTIONAL LIVING, LLC

Practice address

12700 Bowers LN
South Lyon, MI 48178-9133

Phone

(248) 345-4927

NPI assigned

Jan 20, 2017

Last updated

Jan 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hillary Lynne Sullins, LMSW

Title

Managing Director/Owner

Phone

(248) 345-4927

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1568909182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 BOWERS LN",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481789133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 BOWERS LN",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481789133",
            "telephone_number": "248-345-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR INTENTIONAL LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "SULLINS",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR/OWNER",
        "authorized_official_telephone_number": "248-345-4927",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in South Lyon, MI
• Providers in South Lyon, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.