Provider Demographics
NPI:1508428251
Name:LIVE YOUR LIFE COUNSELING & TREATMENT SERVICES LLC
Entity Type:Organization
Organization Name:LIVE YOUR LIFE COUNSELING & TREATMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEVAUGHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-782-9298
Mailing Address - Street 1:11426 DAVIS ST UNIT 1032
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48480-8542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:653 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1512
Practice Address - Country:US
Practice Address - Phone:703-782-9298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty