Provider Demographics
NPI:1699010959
Name:YOUR LIFE COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:YOUR LIFE COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJEFSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:469-569-3945
Mailing Address - Street 1:400 N ALLEN DR
Mailing Address - Street 2:SUITE #103
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2555
Mailing Address - Country:US
Mailing Address - Phone:469-569-3945
Mailing Address - Fax:
Practice Address - Street 1:400 N ALLEN DR
Practice Address - Street 2:SUITE #103
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2555
Practice Address - Country:US
Practice Address - Phone:469-569-3945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX382961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty