Provider Demographics
NPI:1679926083
Name:LIVING IN AUTHORITY, PLLC
Entity Type:Organization
Organization Name:LIVING IN AUTHORITY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:248-924-7999
Mailing Address - Street 1:PO BOX 782242
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-2242
Mailing Address - Country:US
Mailing Address - Phone:248-924-7999
Mailing Address - Fax:915-532-0012
Practice Address - Street 1:9100 W IH 10 STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3113
Practice Address - Country:US
Practice Address - Phone:248-924-7999
Practice Address - Fax:915-532-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3549222Medicaid