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General NPI Number Information
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NPI Number | 1336706027
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Entity Type | Organization
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Legal Business Name | TOTAL LIFE COUNSELING AND CONSULTING SERVICES
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 1949 GOLDSMITH LN STE 103
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City | LOUISVILLE
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State | KY
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Zip | 40218-3096
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Country | US
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Telephone | 502-528-1363
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Fax |
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Provider Business Mailing Address
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Address Line | 9918 CREEK VIEW ESTATES DR
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City | LOUISVILLE
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State | KY
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Zip | 40291-5141
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Country | US
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Telephone | 502-615-0106
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHAUWEDA SMITH
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Credential |
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Telephone | 502-615-0165
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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 |
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License Number State |
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