Organization Name: | L.I.F.E. COUNSELING SERVICES |
NPI Number: | 1639386105 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONNA KAY THOMPSON-LISIECKI (OWNER) |
Mailing Address: | 710 Bowery Ln Building G Box 41 Folkston |
State: | GA US |
Postal Code: | 315375967 |
Phone Number: | 9124962616 |
Fax Number: | 9124962671 |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 10/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC003397 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |