Healthcare Provider Details

I. General information

NPI: 1881486595
Provider Name (Legal Business Name): LIFE SOLUTIONS COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W GREGORY ST
PENSACOLA FL
32502-4820
US

IV. Provider business mailing address

112 W GREGORY ST
PENSACOLA FL
32502-4820
US

V. Phone/Fax

Practice location:
  • Phone: 520-392-0088
  • Fax:
Mailing address:
  • Phone: 520-392-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SHELLY M PARKS
Title or Position: LICENSED ASSOCIATE COUNSELOR
Credential: MSC
Phone: 520-392-0088