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General NPI Number Information
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NPI Number | 1790321958
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Entity Type | Organization
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Legal Business Name | THISLIFE COUNSELING, LLC
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 119 N 6TH AVE
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City | CHATSWORTH
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State | GA
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Zip | 30705-2852
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Country | US
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Telephone | 706-383-7290
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Fax |
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Provider Business Mailing Address
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Address Line | 119 N 6TH AVE
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City | CHATSWORTH
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State | GA
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Zip | 30705-2852
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Country | US
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Telephone | 706-383-7290
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRAVIS MCKIE-VOERSTE
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Credential | PH.D., LPC, ACS
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Telephone | 706-383-7290
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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 | 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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