Provider Demographics
NPI:1295373843
Name:LIFE COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:LIFE COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CSAC, ICS
Authorized Official - Phone:920-931-4229
Mailing Address - Street 1:2807 E LOURDES DRIVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-3914
Mailing Address - Country:US
Mailing Address - Phone:920-931-4229
Mailing Address - Fax:920-706-1477
Practice Address - Street 1:101 W EDISON AVENUE
Practice Address - Street 2:SUITE 117
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1930
Practice Address - Country:US
Practice Address - Phone:920-931-4229
Practice Address - Fax:920-706-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100016657Medicaid