Provider Demographics
NPI:1164090650
Name:LIFENESS COUNSELING, LLC
Entity Type:Organization
Organization Name:LIFENESS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:STEPHANIE
Authorized Official - Last Name:LARA
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMHC
Authorized Official - Phone:413-231-2181
Mailing Address - Street 1:144 NEWHOUSE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-2510
Mailing Address - Country:US
Mailing Address - Phone:413-231-2181
Mailing Address - Fax:
Practice Address - Street 1:15 BENTON DR STE 11
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-3232
Practice Address - Country:US
Practice Address - Phone:413-281-2152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty