Provider Demographics
NPI:1720400831
Name:LIFE COACHING AND THERAPY LLC
Entity Type:Organization
Organization Name:LIFE COACHING AND THERAPY LLC
Other - Org Name:THE SEX DOCTOR LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER AND CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCIUCCO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT, AASECTCST
Authorized Official - Phone:203-733-9600
Mailing Address - Street 1:801 FARMINGTON AVE STE 2C
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1672
Mailing Address - Country:US
Mailing Address - Phone:203-733-9600
Mailing Address - Fax:
Practice Address - Street 1:944 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2228
Practice Address - Country:US
Practice Address - Phone:203-733-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001556251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health