Provider Demographics
NPI:1659980845
Name:LIFEWORKS MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:LIFEWORKS MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:LIFEWORKS MENTAL HEALTH COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:631-664-1582
Mailing Address - Street 1:215 ISLIP AVE
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3028
Mailing Address - Country:US
Mailing Address - Phone:631-664-1582
Mailing Address - Fax:
Practice Address - Street 1:215 ISLIP AVE
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3028
Practice Address - Country:US
Practice Address - Phone:631-664-1582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health