Healthcare Provider Details

I. General information

NPI: 1275499493
Provider Name (Legal Business Name): LIFE WORKS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 BROWNS MILL LN
STONECREST GA
30038-4664
US

IV. Provider business mailing address

13660 TARA HILLS CIR
GULFPORT MS
39503-2331
US

V. Phone/Fax

Practice location:
  • Phone: 228-596-8125
  • Fax:
Mailing address:
  • Phone: 228-596-8125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. COURTNEY DEFLANDERS
Title or Position: FOUNDER AND LEAD THERAPIST
Credential: LPC, CPCS, NCC, NCSA
Phone: 228-596-8125