Organization
HEART SPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA PIA ROSA LINSALATA LMSW SCSW (OWNER)
(248) 894-4573
Entity
Organization
Contact information
Practice address
940 W CLARKSTON RD, LAKE ORION, MI 48362-2575
(248) 894-4573
(248) 690-7030
Mailing address
940 W CLARKSTON RD, LAKE ORION, MI 48362-2575
(248) 894-4573
(248) 690-7030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801079215
MI
1041C0700X
Clinical Social Worker
6801079215
MI
106H00000X
Marriage & Family Therapist
6801079215
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8008987610
BCBS
MI
Enumeration date
07/13/2007
Last updated
07/17/2007
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