Provider Demographics
NPI:1215539218
Name:LIFE'S A JOURNEY COUNSELING, LLC
Entity Type:Organization
Organization Name:LIFE'S A JOURNEY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:TANGUAY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:774-704-6681
Mailing Address - Street 1:122 BUFFINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4810
Mailing Address - Country:US
Mailing Address - Phone:774-704-6681
Mailing Address - Fax:508-617-8096
Practice Address - Street 1:122 BUFFINGTON ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4810
Practice Address - Country:US
Practice Address - Phone:774-704-6681
Practice Address - Fax:508-617-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty