Provider Demographics
NPI:1326511718
Name:MORE LIFE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:MORE LIFE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAVIS-LASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-301-4647
Mailing Address - Street 1:1300 S. WATSON RD. A 114 PMB 256
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-0112
Mailing Address - Country:US
Mailing Address - Phone:602-750-6043
Mailing Address - Fax:
Practice Address - Street 1:5060 N 19TH AVE STE 218
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3212
Practice Address - Country:US
Practice Address - Phone:602-750-6043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty