MEDICARE: LIVE IN FAITH & ENLIGHTENMENT THERAPY 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1295628972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVE IN FAITH & ENLIGHTENMENT THERAPY LLC

Provider Business Mailing Address
First Line	:	34990 EMERALD COAST PKWY STE 366
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-8662
Country	:	US
Telephone Number	:	786-565-2911
Fax Number	:

Provider Business Practice Location Address
First Line	:	34990 EMERALD COAST PKWY STE 366
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-8662
Country	:	US
Telephone Number	:	786-565-2911
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANNEL CURTISS
Credential	:	LCSW
Telephone Number	:	786-565-2911

Provider Enumeration Date	:	05/31/2025
Last Update Date	:	05/31/2025

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