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General NPI Number Information
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NPI Number | 1972348431
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Entity Type | Organization
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Legal Business Name | LIFE ABUNDANTLY LLC
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Dates
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Enumeration Date | 06/26/2024
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 5825 TRIANGLE DR STE 216
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City | RALEIGH
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State | NC
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Zip | 27617-4892
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Country | US
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Telephone | 833-216-0366
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Fax | 833-505-3325
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Provider Business Mailing Address
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Address Line | 5825 TRIANGLE DR STE 216
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City | RALEIGH
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State | NC
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Zip | 27617-4892
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Country | US
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Telephone | 833-216-0366
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Fax | 833-505-3325
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Authorized Official
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Title or Position | FOUNDER
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Name | THADDEUS WILLIAMS
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Credential |
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Telephone | 984-500-7338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 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 #3
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 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 #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #8
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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 #9
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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