Provider Demographics
NPI:1104357326
Name:LIFE AND LOVE COUNSELING LLC
Entity Type:Organization
Organization Name:LIFE AND LOVE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBRE
Authorized Official - Middle Name:LEI
Authorized Official - Last Name:WITTE
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:717-917-5862
Mailing Address - Street 1:205 GRANITE RUN DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6821
Mailing Address - Country:US
Mailing Address - Phone:717-917-5862
Mailing Address - Fax:
Practice Address - Street 1:205 GRANITE RUN DR
Practice Address - Street 2:SUITE 310
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6821
Practice Address - Country:US
Practice Address - Phone:717-917-5862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129118104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty