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General NPI Number Information
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NPI Number | 1760193924
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Entity Type | Organization
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Legal Business Name | LIFT MY SOUL THERAPY SOLUTIONS, LLC
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 305B BATTLE ST E
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City | TALLADEGA
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State | AL
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Zip | 35160-2654
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Country | US
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Telephone | 256-322-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 GOLDEN SPRINGS RD # 345
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City | ANNISTON
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State | AL
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Zip | 36207-6924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COLLEEN CRAIG-AKINSANYA
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Credential | LICSW
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Telephone | 256-322-6886
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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 |
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License Number State |
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