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General NPI Number Information
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NPI Number | 1396171823
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Entity Type | Organization
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Legal Business Name | LIFE'S JOURNEY COUNSELING, LLC
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 266 MAIN ST BUILDING ONE SUITE SEVEN
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City | MEDFIELD
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State | MA
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Zip | 02052-2043
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Country | US
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Telephone | 508-733-4422
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Fax |
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Provider Business Mailing Address
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Address Line | 266 MAIN ST BUILDING ONE SUITE SEVEN
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City | MEDFIELD
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State | MA
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Zip | 02052-2043
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Country | US
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Telephone | 508-733-4422
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. CHRISTINA PLAYER
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Credential | LICSW
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Telephone | 508-733-4422
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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 | 114776
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License Number State | MA
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