Provider Demographics
NPI:1528554714
Name:LIFE COUNSELING FLORIDA, LLC
Entity Type:Organization
Organization Name:LIFE COUNSELING FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:TRAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-714-4403
Mailing Address - Street 1:9230 SE YACHT CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-3246
Mailing Address - Country:US
Mailing Address - Phone:561-714-4403
Mailing Address - Fax:
Practice Address - Street 1:9230 SE YACHT CLUB CIR
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-3246
Practice Address - Country:US
Practice Address - Phone:561-714-4403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13403101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty