MEDICARE: MAKE YOUR LIFE COUNSELING, PLLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1528882966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKE YOUR LIFE COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	2505 VALLEY GLEN CT
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4234
Country	:	US
Telephone Number	:	972-345-4871
Fax Number	:

Provider Business Practice Location Address
First Line	:	2505 VALLEY GLEN CT
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4234
Country	:	US
Telephone Number	:	972-345-4871
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MRS. KIMBERLY ADELE MORTON
Credential	:	LPC-A
Telephone Number	:	972-345-4871

Provider Enumeration Date	:	11/12/2024
Last Update Date	:	11/12/2024

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