Provider Demographics
NPI:1518110246
Name:LIFELINES COUNSELING & FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:LIFELINES COUNSELING & FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:HOWERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MFT
Authorized Official - Phone:949-933-6275
Mailing Address - Street 1:3001 RED HILL AVE
Mailing Address - Street 2:#1-216
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4529
Mailing Address - Country:US
Mailing Address - Phone:949-933-6275
Mailing Address - Fax:714-557-3775
Practice Address - Street 1:3001 RED HILL AVE
Practice Address - Street 2:#1-216
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4529
Practice Address - Country:US
Practice Address - Phone:949-933-6275
Practice Address - Fax:714-557-3775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health