Tranquil Life Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

TRANQUIL LIFE COUNSELING LLC

Practice address

275 S State Rd
Otisville, MI 48463-8436

Phone

(810) 374-6115

NPI assigned

May 22, 2019

Organization subpart

No

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

Authorized official

Name

Amanda Renee Southern, LMSWNPI 1982945549

Title

Owner

Phone

(810) 922-7700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

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

• Amanda Renee Southern, LMSW

  • Clinical Social Worker
  • Otisville, MI
  • NPI 1982945549
  Medicare reassignment Care Compare group NPD Authorized official
• Kimberly Michelle Redmond, LMSW-C

  • Clinical Social Worker
  • Flint, MI
  • NPI 1952750044
  Medicare reassignment Care Compare group NPD
• Rhonda Hargan

  • Counselor
  • Flint, MI
  • NPI 1164829560
  Medicare reassignment NPD
• Crystal Marie Hurteau, LMSW, QMRP

  • Clinical Social Worker
  • Flint, MI
  • NPI 1528309184
  Medicare reassignment NPD
• Tanya Roe, LMSW

  • Clinical Social Worker
  • Clarkston, MI
  • NPI 1164852430
  Medicare reassignment NPD

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1851958151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S STATE RD",
            "city": "OTISVILLE",
            "state": "MI",
            "postal_code": "484638436",
            "telephone_number": "810-374-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S STATE RD",
            "city": "OTISVILLE",
            "state": "MI",
            "postal_code": "484638436",
            "telephone_number": "810-374-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANQUIL LIFE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "SOUTHERN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-922-7700",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Otisville Pharmacy LLC
• Rite Aid of Michigan Inc
• Amanda Renee Southern, LMSW
• Kasey Marie Stark, DDS
• Kathy Taliaferro
• William Wise

• Mental Health Counselor in Otisville, MI
• Providers in Otisville, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.