Healthcare Provider Details

I. General information

NPI: 1427354901
Provider Name (Legal Business Name): LIFE STRATEGIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 N CALUMET RD SUITE 100
CHESTERTON IN
46304-2489
US

IV. Provider business mailing address

4989 W 450 N
LA PORTE IN
46350-7403
US

V. Phone/Fax

Practice location:
  • Phone: 219-359-3272
  • Fax:
Mailing address:
  • Phone: 219-508-1594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: AUTUMN M. VENDRAMIN
Title or Position: OWNER
Credential: LMHC, BCBA
Phone: 219-508-1594