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General NPI Number Information
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NPI Number | 1033749106
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Entity Type | Organization
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Legal Business Name | LIFE SOLUTIONS COUNSELING SERVICES
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 7330 W COLLEGE DR STE 207
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1157
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Country | US
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Telephone | 708-568-1479
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Fax |
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Provider Business Mailing Address
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Address Line | 4608 W 99TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-3134
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Country | US
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Telephone | 773-573-3206
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MR. JAMES PHELAN
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Credential | LCPC
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Telephone | 773-573-3206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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