Provider Demographics
NPI:1497461669
Name:BETTER LIFE COUNSELING, LLC
Entity Type:Organization
Organization Name:BETTER LIFE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:DIRKSE-GRAW
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-516-8073
Mailing Address - Street 1:4618 CLOUDCREST DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9050
Mailing Address - Country:US
Mailing Address - Phone:503-516-8073
Mailing Address - Fax:
Practice Address - Street 1:16 N RIVERSIDE AVE STE 209
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-6024
Practice Address - Country:US
Practice Address - Phone:503-516-8073
Practice Address - Fax:202-788-6366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500815409Medicaid