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General NPI Number Information
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NPI Number | 1598272239
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Entity Type | Organization
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Legal Business Name | LIFE INSPIRED COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 7577 CENTRAL PARKE BLVD STE 218
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City | MASON
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State | OH
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Zip | 45040-6817
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Country | US
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Telephone | 513-904-9322
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Fax | 844-740-0064
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Provider Business Mailing Address
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Address Line | 7577 CENTRAL PARKE BLVD STE 218
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City | MASON
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State | OH
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Zip | 45040-6817
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Country | US
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Telephone | 513-904-9322
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Fax | 844-740-0064
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. PAULA C LANGE
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Credential | LISW-S
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Telephone | 513-904-9322
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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 | I.1451140.SUPV
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License Number State | OH
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