Healthcare Provider Details
I. General information
NPI: 1326511718
Provider Name (Legal Business Name): MORE LIFE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2019
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5060 N 19TH AVE STE 218
PHOENIX AZ
85015-3212
US
IV. Provider business mailing address
1300 S. WATSON RD. A 114 PMB 256
BUCKEYE AZ
85326-0112
US
V. Phone/Fax
- Phone: 602-750-6043
- Fax:
- Phone: 602-750-6043
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name: MRS.
KATHRYN
D
DAVIS-LASHLEY
Title or Position: OWNER
Credential: LPC
Phone: 602-301-4647