=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174898803
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIVING BETTER INSTITUTE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2012
-----------------------------------------------------
Last Update Date | 03/13/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 529 ROUTE 515 SUITE 203A
-----------------------------------------------------
City | VERNON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07462-3166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-670-7215
-----------------------------------------------------
Fax | 973-209-1702
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 529 ROUTE 515 SUITE 203A
-----------------------------------------------------
City | VERNON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07462-3166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-670-7215
-----------------------------------------------------
Fax | 973-209-1702
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. CHARLES MARKHAM
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 973-670-7215
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 37PC00417100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------