Healthcare Provider Details

I. General information

NPI: 1164872826
Provider Name (Legal Business Name): LIFE SOLUTIONS COUNSELING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 PARK CENTER DR STE 101
ORLANDO FL
32835-6216
US

IV. Provider business mailing address

1803 PARK CENTER DR STE 101
ORLANDO FL
32835-6216
US

V. Phone/Fax

Practice location:
  • Phone: 813-895-8278
  • Fax:
Mailing address:
  • Phone: 813-895-8278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMT2932
License Number StateFL

VIII. Authorized Official

Name: REBEKAH ESGUERRA
Title or Position: LMFT
Credential: LMFT
Phone: 813-895-8278