Provider Demographics
NPI:1033749106
Name:LIFE SOLUTIONS COUNSELING SERVICES
Entity Type:Organization
Organization Name:LIFE SOLUTIONS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PHELAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-573-3206
Mailing Address - Street 1:4608 W 99TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3134
Mailing Address - Country:US
Mailing Address - Phone:773-573-3206
Mailing Address - Fax:
Practice Address - Street 1:7330 W COLLEGE DR STE 207
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1157
Practice Address - Country:US
Practice Address - Phone:708-568-1479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty