Provider Demographics
NPI:1043616915
Name:LIFE SOLUTIONS COUNSELING
Entity Type:Organization
Organization Name:LIFE SOLUTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANISE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-286-8934
Mailing Address - Street 1:205 20TH ST N
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3609
Mailing Address - Country:US
Mailing Address - Phone:205-286-8934
Mailing Address - Fax:205-623-3733
Practice Address - Street 1:205 20TH ST N
Practice Address - Street 2:SUITE 410
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-3609
Practice Address - Country:US
Practice Address - Phone:205-286-8934
Practice Address - Fax:205-623-3733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty