Healthcare Provider Details

I. General information

NPI: 1982422259
Provider Name (Legal Business Name): ALIVE EXPLORATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 ENGLAND ST # 56
ASHLAND VA
23005-9998
US

IV. Provider business mailing address

301 ENGLAND ST # 56
ASHLAND VA
23005-9998
US

V. Phone/Fax

Practice location:
  • Phone: 804-404-5593
  • Fax:
Mailing address:
  • Phone: 804-404-5593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: ANDREA SHIPLEY
Title or Position: OWNER
Credential: LPC
Phone: 804-404-5593