Provider Demographics
NPI:1508407396
Name:GOOD LIFE COUNSELING, LLC
Entity Type:Organization
Organization Name:GOOD LIFE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, CSOTP
Authorized Official - Phone:804-402-4754
Mailing Address - Street 1:113 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-2360
Mailing Address - Country:US
Mailing Address - Phone:804-402-4754
Mailing Address - Fax:
Practice Address - Street 1:1 MILL ST STE 201
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3401
Practice Address - Country:US
Practice Address - Phone:434-207-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty