Healthcare Provider Details

I. General information

NPI: 1285317347
Provider Name (Legal Business Name): LIFE SOLUTIONS THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 CARLTON DR
RACINE WI
53402-3312
US

IV. Provider business mailing address

1220 CARLTON DR
RACINE WI
53402-3312
US

V. Phone/Fax

Practice location:
  • Phone: 262-321-8490
  • Fax: 262-218-4442
Mailing address:
  • Phone: 262-321-8490
  • Fax: 262-218-4442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DANIEL JAMES DASHNER
Title or Position: OWNER
Credential: LCSW, CSAC
Phone: 262-321-8490