MEDICARE: LIFE SPEAKS MOTIVATIONAL MANAGEMENT GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1700450699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE SPEAKS MOTIVATIONAL MANAGEMENT GROUP LLC

Provider Business Mailing Address
First Line	:	925 MAIN ST STE 200
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3097
Country	:	US
Telephone Number	:	678-476-3775
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 MAIN ST STE 200
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3097
Country	:	US
Telephone Number	:	678-476-3775
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAREN T SHIRLEY
Credential	:	LIFE COACH
Telephone Number	:	678-476-3775

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	03/20/2026

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