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NPI Code Detail

MEDICARE: LIFE STRATEGIES COUNSELING, INC.

MEDICARE: LIFE STRATEGIES COUNSELING, INC.
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
1261QM0855XAdolescent and Children Mental Health Clinic/Center
2261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1700426731
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE STRATEGIES COUNSELING, INC.
Provider Business Mailing Address
First Line : 2809 FOREST HOME RD
Second Line :
City : JONESBORO
State : AR
Zip : 72401-5320
Country : US
Telephone Number : 866-972-1268
Fax Number :
Provider Business Practice Location Address
First Line : 2020 E JOYCE BLVD STE 1
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-6228
Country : US
Telephone Number : 479-332-4557
Fax Number : 479-435-9587
Authorized Official
Title or Position : CEO
Name : JAVIER MALAVE
Credential :
Telephone Number : 904-605-4986
Provider Enumeration Date : 01/07/2020
Last Update Date : 07/14/2023

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Directions to “LIFE STRATEGIES COUNSELING, INC. ” Practice Location

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