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General NPI Number Information
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NPI Number | 1609350651
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Entity Type | Organization
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Legal Business Name | LIFE-SPIRE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 09/16/2018
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 780 DELTONA BLVD STE 102
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City | DELTONA
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State | FL
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Zip | 32725-7128
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Country | US
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Telephone | 386-400-3100
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Fax | 386-968-3257
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Provider Business Mailing Address
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Address Line | 780 DELTONA BLVD STE 102
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City | DELTONA
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State | FL
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Zip | 32725-7128
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Country | US
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Telephone | 386-400-3100
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Fax | 386-968-3257
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Authorized Official
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Title or Position | OWNER
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Name | JANAE PONDER
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Credential | MSW, LCSW
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Telephone | 386-400-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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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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