Provider Demographics
NPI:1114409794
Name:LIFE SOLUTIONS COACHING COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:LIFE SOLUTIONS COACHING COUNSELING & CONSULTING LLC
Other - Org Name:LIFE SOLUTIONS COACHING COUNSELING & CONSULTING LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-OWNER, CO-EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:330-459-5051
Mailing Address - Street 1:1485 S HAWKINS AVE STE 150G
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3475
Mailing Address - Country:US
Mailing Address - Phone:234-571-0039
Mailing Address - Fax:
Practice Address - Street 1:1485 S HAWKINS AVE STE 150G
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3475
Practice Address - Country:US
Practice Address - Phone:234-571-0039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1200466104100000X
OHI.070003241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty