Provider Demographics
NPI:1346089927
Name:EQUILIBRIUM THERAPY AND WELLNESS, PLLC
Entity type:Organization
Organization Name:EQUILIBRIUM THERAPY AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTEONI-LOSIEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:269-528-4258
Mailing Address - Street 1:7289 HUNTERS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-7749
Mailing Address - Country:US
Mailing Address - Phone:269-599-3002
Mailing Address - Fax:
Practice Address - Street 1:5955 W MAIN ST STE 211
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-9101
Practice Address - Country:US
Practice Address - Phone:269-528-4258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health