Provider Demographics
NPI:1518264100
Name:CONSULTING, LIFECOACHING & PSCHOTHERAPY,LLC
Entity Type:Organization
Organization Name:CONSULTING, LIFECOACHING & PSCHOTHERAPY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:KIMBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-826-7909
Mailing Address - Street 1:100 S LIMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-3655
Mailing Address - Country:US
Mailing Address - Phone:660-826-7909
Mailing Address - Fax:660-826-6737
Practice Address - Street 1:100 S LIMIT AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-3655
Practice Address - Country:US
Practice Address - Phone:660-826-7909
Practice Address - Fax:660-826-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty