Provider Demographics
NPI:1629471628
Name:LIFE & WELLNESS COUNSELING AND COUNSULTING
Entity Type:Organization
Organization Name:LIFE & WELLNESS COUNSELING AND COUNSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEGRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCA
Authorized Official - Phone:704-305-8026
Mailing Address - Street 1:16507 NORTHCROSS DR STE A
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5082
Mailing Address - Country:US
Mailing Address - Phone:704-305-8026
Mailing Address - Fax:425-696-2262
Practice Address - Street 1:16507 NORTHCROSS DR STE A
Practice Address - Street 2:SUITE 105
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5082
Practice Address - Country:US
Practice Address - Phone:704-305-8026
Practice Address - Fax:425-696-2262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty