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General NPI Number Information
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NPI Number | 1134642754
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Entity Type | Organization
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Legal Business Name | LIFECARE COUNSELING AND COACHING
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 280 W MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-2749
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Country | US
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Telephone | 276-415-0311
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Fax | 276-335-0126
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Provider Business Mailing Address
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Address Line | 117 KINGSPORT RD
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-9221
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Country | US
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Telephone | 919-753-3368
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MR. GERALD W LANKFORD JR.
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Credential | LPC
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Telephone | 276-415-0311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006875
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License Number State | VA
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