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General NPI Number Information
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NPI Number | 1649694175
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Entity Type | Organization
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Legal Business Name | LIFEWAY COUNSELING, LLC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 710 COOPER AVE STE 120
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-3455
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Country | US
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Telephone | 970-945-9841
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Fax | 970-945-2121
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Provider Business Mailing Address
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Address Line | 710 COOPER AVE STE 120
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-3455
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Country | US
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Telephone | 970-945-9841
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Fax | 970-945-2121
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. KAREN LEANN NADON
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Credential | MA, LPC
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Telephone | 970-945-9841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5221
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License Number State | CO
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