Healthcare Provider Details

I. General information

NPI: 1437791209
Provider Name (Legal Business Name): LIFE IN MOTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8106 RED STONE HILL RD
LOUISVILLE KY
40214-4614
US

IV. Provider business mailing address

8106 RED STONE HILL RD
LOUISVILLE KY
40214-4614
US

V. Phone/Fax

Practice location:
  • Phone: 502-438-6460
  • Fax: 833-953-0891
Mailing address:
  • Phone: 502-438-6460
  • Fax: 833-953-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA DEAN SMITH
Title or Position: OWNER
Credential: LMFT
Phone: 502-438-6460