Healthcare Provider Details

I. General information

NPI: 1033022207
Provider Name (Legal Business Name): MY LIFESPAN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5908 BRYANT ST
PITTSBURGH PA
15206-1606
US

IV. Provider business mailing address

915 FARRAGUT ST
PITTSBURGH PA
15206-2203
US

V. Phone/Fax

Practice location:
  • Phone: 412-532-8576
  • Fax:
Mailing address:
  • Phone: 412-532-8576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOAN SOULLIERE
Title or Position: OWNER
Credential: LCSW
Phone: 412-532-8576