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General NPI Number Information
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NPI Number | 1083985972
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Entity Type | Organization
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Legal Business Name | WHOLE LIFE COUNSELING, LLC
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 450 N MAIN ST
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City | SHARON
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State | MA
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Zip | 02067-1172
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Country | US
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Telephone | 508-648-1793
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Fax |
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Provider Business Mailing Address
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Address Line | 450 N MAIN ST
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City | SHARON
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State | MA
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Zip | 02067-1172
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Country | US
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Telephone | 508-648-1793
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. PATRICIA ADAMS KISSINGER
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Credential | LICSW
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Telephone | 508-648-1793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 114970
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License Number State | MA
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