Provider Demographics
NPI:1598517690
Name:LIFEKNIT COUNSELING LLC
Entity Type:Organization
Organization Name:LIFEKNIT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GIFTY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PAMPURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-218-1555
Mailing Address - Street 1:6394 GREYSTONE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-7527
Mailing Address - Country:US
Mailing Address - Phone:804-252-7292
Mailing Address - Fax:
Practice Address - Street 1:6394 GREYSTONE CREEK RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-7527
Practice Address - Country:US
Practice Address - Phone:804-252-7292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty