Active NPI
Life Coach Psychology PLC
- Clinical Psychologist
- Berrien Springs, MI
National Provider Identifier
1831495993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301010743
- Legal business name
- LIFE COACH PSYCHOLOGY PLC
- Practice address
- 300 W Ferry St
Berrien Springs, MI 49103-1109 - Phone
- (269) 815-5331
- Fax
- (269) 815-5061
- NPI assigned
- Feb 7, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Harold B Smith, PSY D
- Title
- Owner
- Phone
- (269) 815-5331
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301010743 | MI | Primary |
Addresses
Primary practice location
300 W Ferry St
Berrien Springs, MI 49103-1109
Mailing address
300 W Ferry St
Berrien Springs, MI 49103-1109
Phone (269) 815-5331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110426000255 | MI | Part B Supplier - Clinic/Group Practice | 9133304744 |
Receives reassigned benefits from 15 practitioners Practice locations: Berrien Springs, MI |
National Provider Directory
National Provider Directory- Tax ID family
- Life Coach Psychology
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Berrien Springs, MI
- NPI 1023317161
Locations
2775 W Dickman Rd
Ste P1
Springfield, MI 49037
Phone (269) 883-6560
Practitioners & affiliated clinicians
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Addiction (Substance Use Disorder) Counselor
- Battle Creek, MI
- NPI 1396987533
MI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297036800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1494460800000",
"number": "1831495993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W FERRY ST",
"city": "BERRIEN SPRINGS",
"state": "MI",
"postal_code": "491031109",
"telephone_number": "269-815-5331",
"fax_number": "269-815-5061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W FERRY ST",
"city": "BERRIEN SPRINGS",
"state": "MI",
"postal_code": "491031109",
"telephone_number": "269-815-5331",
"fax_number": "269-815-5061"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE COACH PSYCHOLOGY PLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-07",
"last_updated": "2017-05-11",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "HAROLD",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "269-815-5331",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSY D"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301010743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berrien Springs, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.