Provider Demographics
NPI:1093568693
Name:UPLIFTING LIVES AND SERVICES LLC
Entity Type:Organization
Organization Name:UPLIFTING LIVES AND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:804-901-1842
Mailing Address - Street 1:6601 IRONGATE SQ STE D
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6077
Mailing Address - Country:US
Mailing Address - Phone:804-901-1842
Mailing Address - Fax:804-942-0600
Practice Address - Street 1:6601 IRONGATE SQ STE D
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-6077
Practice Address - Country:US
Practice Address - Phone:804-901-1842
Practice Address - Fax:804-942-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty