Healthcare Provider Details

I. General information

NPI: 1609669936
Provider Name (Legal Business Name): LIFE CENTER COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 S WESTERN AVE
MARION IN
46953-5778
US

IV. Provider business mailing address

5230 S WESTERN AVE
MARION IN
46953-5778
US

V. Phone/Fax

Practice location:
  • Phone: 765-674-2208
  • Fax: 765-674-3273
Mailing address:
  • Phone: 765-674-2208
  • Fax: 765-674-3273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: APRIL LEACH
Title or Position: OFFICE MANAGER
Credential:
Phone: 765-674-2208