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General NPI Number Information
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NPI Number | 1588311922
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Entity Type | Organization
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Legal Business Name | LIFESPAN COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 03/06/2022
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Last Update Date | 03/06/2022
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Provider Practice Location Address
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Address Line | 14952 NEWPORT RD
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City | CLEARWATER
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State | FL
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Zip | 33764-7085
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Country | US
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Telephone | 727-214-8267
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Fax |
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Provider Business Mailing Address
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Address Line | 14952 NEWPORT RD
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City | CLEARWATER
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State | FL
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Zip | 33764-7085
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Country | US
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Telephone | 172-721-4826
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Fax | 727-475-8965
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DIANA LOUISE CASCIATO
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Credential |
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Telephone | 727-214-8267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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