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General NPI Number Information
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NPI Number | 1467906362
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Entity Type | Organization
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Legal Business Name | LIFELINE COUNSELING AND EDUCATIONAL SERVICES
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Dates
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Enumeration Date | 08/09/2016
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 1701 E LA HABRA BLVD STE C
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City | LA HABRA
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State | CA
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Zip | 90631-4977
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Country | US
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Telephone | 562-706-4251
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 E LA HABRA BLVD STE C
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City | LA HABRA
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State | CA
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Zip | 90631-4977
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Country | US
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Telephone | 562-706-4251
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MRS. EMILY WOLFE
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Credential |
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Telephone | 562-943-1799
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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 | CATCV 157107
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCI 3095
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC42888
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License Number State | CA
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