MEDICARE: LIVE UP COLLECTIVE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1285440214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVE UP COLLECTIVE LLC

Provider Business Mailing Address
First Line	:	6820 GARFIELD AVE
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-2331
Country	:	US
Telephone Number	:	952-457-3189
Fax Number	:

Provider Business Practice Location Address
First Line	:	6820 GARFIELD AVE
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-2331
Country	:	US
Telephone Number	:	952-457-3189
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF MENTAL HEALTH
Name	:	CLAIRE VOEKS
Credential	:	LICSW
Telephone Number	:	952-457-3189

Provider Enumeration Date	:	12/04/2024
Last Update Date	:	12/04/2024

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Directions to “LIVE UP COLLECTIVE LLC ” Practice Location

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