Provider Demographics
NPI:1427838382
Name:PRINCIPLE THERAPY & WELLNESS
Entity type:Organization
Organization Name:PRINCIPLE THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARZETTE
Authorized Official - Last Name:PLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LPCC
Authorized Official - Phone:269-359-1179
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49081-0194
Mailing Address - Country:US
Mailing Address - Phone:269-359-1179
Mailing Address - Fax:
Practice Address - Street 1:1151 W MILHAM AVE # 194
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-1203
Practice Address - Country:US
Practice Address - Phone:269-359-1179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty