Provider Demographics
NPI:1619015302
Name:LIFE SOLUTIONS INC OF ALEX
Entity Type:Organization
Organization Name:LIFE SOLUTIONS INC OF ALEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT LIFE SOLUTIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIRARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LMFT
Authorized Official - Phone:318-449-8571
Mailing Address - Street 1:5501 JOHN ESKEW BLVD
Mailing Address - Street 2:C
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303
Mailing Address - Country:US
Mailing Address - Phone:318-449-8571
Mailing Address - Fax:318-449-8506
Practice Address - Street 1:5501 JOHN ESKEW BLVD
Practice Address - Street 2:C
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303
Practice Address - Country:US
Practice Address - Phone:318-449-8571
Practice Address - Fax:318-449-8506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101Y00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty