Healthcare Provider Details
I. General information
NPI: 1700450699
Provider Name (Legal Business Name): LIFE SPEAKS MOTIVATIONAL MANAGEMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2021
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
925 MAIN ST STE 200
STONE MOUNTAIN GA
30083-3097
US
IV. Provider business mailing address
925 MAIN ST STE 200
STONE MOUNTAIN GA
30083-3097
US
V. Phone/Fax
- Phone: 678-476-3775
- Fax:
- Phone: 678-476-3775
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
T
SHIRLEY
Title or Position: OWNER
Credential: LIFE COACH
Phone: 678-476-3775