Provider Demographics
NPI:1659146322
Name:GOOD LYFE CONSULTING LLC
Entity Type:Organization
Organization Name:GOOD LYFE CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BOHANEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLPC CTP
Authorized Official - Phone:248-242-2055
Mailing Address - Street 1:29600 PICKFORD ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3464
Mailing Address - Country:US
Mailing Address - Phone:248-242-2055
Mailing Address - Fax:
Practice Address - Street 1:29600 PICKFORD ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3464
Practice Address - Country:US
Practice Address - Phone:248-242-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIDNEY BOHANEN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty