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General NPI Number Information
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NPI Number | 1750696662
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Entity Type | Organization
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Legal Business Name | LIFESONG COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 11/27/2018
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Provider Practice Location Address
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Address Line | 1425 W. ELLIOT RD SUITE 207
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City | GILBERT
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State | AZ
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Zip | 85233-8720
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Country | US
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Telephone | 480-656-8349
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 W. ELLIOT RD SUITE 207
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City | GILBERT
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State | AZ
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Zip | 85233-8720
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Country | US
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Telephone | 480-656-8349
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. WENDY SUE LEHNERTZ
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Credential | LMFT
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Telephone | 480-656-8349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-10262
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License Number State | AZ
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