Healthcare Provider Details

I. General information

NPI: 1285222620
Provider Name (Legal Business Name): LIFE RINGS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2020
Last Update Date: 12/31/2020
Certification Date: 12/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 GARDEN AVE STE 210
EUGENE OR
97403-1965
US

IV. Provider business mailing address

1907 GARDEN AVE STE 210
EUGENE OR
97403-1965
US

V. Phone/Fax

Practice location:
  • Phone: 541-897-7703
  • Fax: 458-210-2848
Mailing address:
  • Phone: 541-897-7703
  • Fax: 458-210-2848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANGELA THOMAS
Title or Position: MENTAL HEALTH THERAPIST
Credential: LCSW
Phone: 541-897-7703