Healthcare Provider Details
I. General information
NPI: 1730016536
Provider Name (Legal Business Name): LIFE'S STUDIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5865 RIDGEWAY CENTER PKWY STE 300
MEMPHIS TN
38120-4014
US
IV. Provider business mailing address
5865 RIDGEWAY CENTER PKWY STE 300
MEMPHIS TN
38120-4014
US
V. Phone/Fax
- Phone: 901-849-1932
- Fax:
- Phone: 901-849-1932
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAY
ALLEN
STONE
Title or Position: DIRECTOR
Credential: LCSW
Phone: 901-849-1932