Healthcare Provider Details

I. General information

NPI: 1639324817
Provider Name (Legal Business Name): LIFESOLUTIONS COUNSELING ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1185 W CARMEL DR STE D4
CARMEL IN
46032-8708
US

IV. Provider business mailing address

1185 W CARMEL DR STE D4
CARMEL IN
46032-8708
US

V. Phone/Fax

Practice location:
  • Phone: 317-569-5433
  • Fax:
Mailing address:
  • Phone: 317-569-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39001690A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34005107A
License Number StateIN

VIII. Authorized Official

Name: ELISABETH PESCE
Title or Position: SECRETARY
Credential:
Phone: 904-605-4986