Provider Demographics
NPI:1306220371
Name:LIFE BUILDERS COUNSELING CENTER
Entity Type:Organization
Organization Name:LIFE BUILDERS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-565-0014
Mailing Address - Street 1:833 W PERSHING RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-1537
Mailing Address - Country:US
Mailing Address - Phone:217-565-0014
Mailing Address - Fax:
Practice Address - Street 1:833 W PERSHING RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1537
Practice Address - Country:US
Practice Address - Phone:217-565-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-19
Last Update Date:2015-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health