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Organization

LIFE CHANGE THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIGID HAVENS LPC (COUNSELOR)
(906) 319-8725
Entity
Organization

Contact information

Practice address
4612 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49525-1229
(906) 319-8725
Mailing address
2222 W GRAND RIVER AVE STE A, OKEMOS, MI 48864-1604
(906) 319-8725

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/17/2025
Last updated
06/02/2026
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