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General NPI Number Information
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NPI Number | 1114256294
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Entity Type | Organization
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Legal Business Name | LIFEWORKS COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 3616 BAILEY RIDGE CIRCLE
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 651-270-9591
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Fax | 651-739-8809
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Provider Business Mailing Address
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Address Line | 3616 BAILEY RIDGE CIRCLE
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 651-270-9591
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Fax | 651-739-8809
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHEILA DWYER
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Credential |
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Telephone | 651-270-9591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 303027
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1693
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License Number State | MN
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