Provider Demographics
NPI:1285191148
Name:LIFE AFTER LOSS COUNSELING, LLC
Entity Type:Organization
Organization Name:LIFE AFTER LOSS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ILISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUCOAT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, FT
Authorized Official - Phone:267-227-0741
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-0008
Mailing Address - Country:US
Mailing Address - Phone:267-227-0741
Mailing Address - Fax:
Practice Address - Street 1:1534 W BROAD ST STE 500
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1018
Practice Address - Country:US
Practice Address - Phone:267-227-0741
Practice Address - Fax:267-828-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty