Healthcare Provider Details

I. General information

NPI: 1417428939
Provider Name (Legal Business Name): LIFE CARE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2018
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9362 TEDDY LN STE 202
LONE TREE CO
80124-2871
US

IV. Provider business mailing address

10234 RUSTIC REDWOOD LN
HIGHLANDS RANCH CO
80126-5543
US

V. Phone/Fax

Practice location:
  • Phone: 720-460-1576
  • Fax:
Mailing address:
  • Phone: 720-460-1576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KERRI LYNNE AST
Title or Position: OWNER
Credential: LPCC
Phone: 720-460-1576