Provider Demographics
NPI:1598272239
Name:LIFE INSPIRED COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:LIFE INSPIRED COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:513-904-9322
Mailing Address - Street 1:7577 CENTRAL PARKE BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6817
Mailing Address - Country:US
Mailing Address - Phone:513-904-9322
Mailing Address - Fax:844-740-0064
Practice Address - Street 1:7577 CENTRAL PARKE BLVD STE 218
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6817
Practice Address - Country:US
Practice Address - Phone:513-904-9322
Practice Address - Fax:844-740-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1451140.SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty