Healthcare Provider Details

I. General information

NPI: 1609374040
Provider Name (Legal Business Name): LIFE TRANSITIONS L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 PACIFIC AVE STE C3
TACOMA WA
98408
US

IV. Provider business mailing address

6201 PACIFIC AVE STE C3
TACOMA WA
98408-7423
US

V. Phone/Fax

Practice location:
  • Phone: 253-363-8853
  • Fax: 253-292-1919
Mailing address:
  • Phone: 253-363-1453
  • Fax: 253-292-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF60659528
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. TROY A HUFFMAN
Title or Position: DIRECTOR OF SERVICES
Credential:
Phone: 253-363-1453