Provider Demographics
NPI:1003287145
Name:THE MEANINGFUL LIFE CENTER, LLC
Entity Type:Organization
Organization Name:THE MEANINGFUL LIFE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:DORA
Authorized Official - Last Name:MEYER-GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LMFT
Authorized Official - Phone:407-534-0186
Mailing Address - Street 1:11315 CORPORATE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-8340
Mailing Address - Country:US
Mailing Address - Phone:407-534-0186
Mailing Address - Fax:321-972-3982
Practice Address - Street 1:11315 CORPORATE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-8340
Practice Address - Country:US
Practice Address - Phone:407-534-0186
Practice Address - Fax:321-972-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11960101YM0800X
FLMT2812106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty