Provider Demographics
NPI:1710755004
Name:LFC MEDICAID THERAPISTS, LLC
Entity Type:Organization
Organization Name:LFC MEDICAID THERAPISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-725-6782
Mailing Address - Street 1:924 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1854
Mailing Address - Country:US
Mailing Address - Phone:303-604-6373
Mailing Address - Fax:
Practice Address - Street 1:924 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1854
Practice Address - Country:US
Practice Address - Phone:303-604-6373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOUISVILLE FAMILY CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-15
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty