INTENTIONAL WELLBEING LLC (NPI# 1366994410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366994410 |
| Entity Type | Organization |
| Organization Name | INTENTIONAL WELLBEING LLC |
| Practice Address |
1122 N. Leroy Rd Suite A Fenton MI 48430 |
| Practice Telephone | 8103735591 |
| Mailing Telephone | 8103735591 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2020-09-25 |
| Authorized Official Name | DR. CRISTINA LECLAIR (OWNER) |
| Authorized Official Telephone | 8103735591 |
| Authorized Official Credential | PSYD LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
6301015165 | MI | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
1122 N. LEROY RD SUITE A |
| City | FENTON |
| State | MI |
| Zip Code | 48430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| 1477978732 | Grant Flood | Social Worker | 1100 Torrey Rd., St. 100, Fenton, MI 48430 | 2014-02-24 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932592854 | Andrea W Casey | Psychologist | 119 S Leroy St, C/o Hope Counseling Center, Fenton, MI 48430-2637 | 2015-03-17 |
| 1588991848 | Dawn Marie Mcfarland | Psychologist | 1101 Gravois Rd, Ste B, Fenton, MO 63026-4580 | 2009-11-06 |
| 1538107008 | Institute for Christian Counseling PC | Psychologist | 12470 Margaret Dr, Fenton, MI 48430-8856 | 2006-06-04 |
| 1598246175 | John Edward Ross | Psychologist | 127 N River St, Fenton, MI 48430-3800 | 2018-08-22 |
| 1528386075 | Dawn Mcfarland Psyd LLC | Psychologist | 1101 Gravois Rd, Suite B, Fenton, MO 63026-4580 | 2010-05-07 |
| 1821221631 | Jennifer Lenore Flack | Psychologist | 127 N River St, Fenton, MI 48430-3800 | 2009-08-26 |
| 1124233549 | P. Douglas Callan & Assoc Ltd | Psychologist | 1361 N Long Lake Rd, Fenton, MI 48430-8867 | 2007-05-11 |
| 1053493825 | Thomas Frederick Curran | Psychologist | 110 Mill St, Fenton, MI 48430-2818 | 2006-10-20 |
| 1407953037 | Paul Douglas Callan | Psychologist | 1361 N Long Lake Rd, Fenton, MI 48430-8867 | 2006-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831296 | Reema S. Beri, Phd, LLC | Psychologist | 49410 Waterstone Estates Cir, Northville, MI 48168-4900 | 2020-11-05 |
| 1952901225 | Northerner Psychological Services, Pllc | Psychologist | 1869 Melbourne St, Birmingham, MI 48009-1160 | 2020-10-27 |
| 1083213631 | Robert J. Sheppard Phd Pllc | Psychologist | 8339 Brookwood Dr, Portage, MI 49024-5207 | 2020-10-23 |
| 1952900037 | Jamila Simone Steward | Psychologist | 31275 Northwestern Hwy Ste 216, Farmington Hills, MI 48334-2570 | 2020-10-20 |
| 1992303465 | Madison Bryant | Psychologist | 1231 S Cass Lake Rd, Waterford, MI 48328-4739 | 2020-10-15 |
| 1730787664 | Athal Yako | Psychologist | 18230 Teresa Dr, Macomb, MI 48044-1681 | 2020-10-13 |
| 1538767678 | Up Telehealth, LLC | Psychologist | 228 W Washington St Ste 7, Marquette, MI 49855-4330 | 2020-10-12 |
| 1881292076 | Meaningful Change: Clinical & Consultation Psychology, Pllc | Psychologist | 1861 Woodland Dr, Mount Pleasant, MI 48858-1298 | 2020-10-11 |
| 1902404122 | Dorrean Riley | Psychologist | 19189 Lexington, Redford, MI 48240-2618 | 2020-10-09 |
| 1174130850 | Timber Creek Counseling West LLC | Psychologist | 2976 Ivanrest Ave Sw Ste 215, Grandville, MI 49418-1440 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.