Provider Demographics
NPI:1689148777
Name:LIFE WORKS PROFESSIONAL COUNSELING, PLLC
Entity Type:Organization
Organization Name:LIFE WORKS PROFESSIONAL COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF SINGLE MEMBER LLC
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:434-990-1744
Mailing Address - Street 1:8767 SEMINOLE TRL STE 101
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-3494
Mailing Address - Country:US
Mailing Address - Phone:434-990-1744
Mailing Address - Fax:434-939-9401
Practice Address - Street 1:8767 SEMINOLE TRL STE 101
Practice Address - Street 2:
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-3494
Practice Address - Country:US
Practice Address - Phone:434-990-1744
Practice Address - Fax:434-939-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty