Provider Demographics
NPI:1679196620
Name:LA VIDA COUNSELING, PLLC
Entity Type:Organization
Organization Name:LA VIDA COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCS, LCAS
Authorized Official - Phone:980-239-7910
Mailing Address - Street 1:250 N TRADE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-9433
Mailing Address - Country:US
Mailing Address - Phone:980-239-7910
Mailing Address - Fax:
Practice Address - Street 1:250 N TRADE ST STE 206
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-9433
Practice Address - Country:US
Practice Address - Phone:980-202-2288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty