Provider Demographics
NPI:1700237039
Name:LIVE AND LEARN INC.
Entity Type:Organization
Organization Name:LIVE AND LEARN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST,PSYCHOMETRIST,
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMILLA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:601-384-7551
Mailing Address - Street 1:989 GREYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2251
Mailing Address - Country:US
Mailing Address - Phone:601-384-7551
Mailing Address - Fax:
Practice Address - Street 1:353 BELLS FERRY DR
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2258
Practice Address - Country:US
Practice Address - Phone:601-384-7551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2191101YM0800X, 101YP2500X, 102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty