Provider Demographics
NPI:1730653312
Name:NOVO LIFE COUNSELING
Entity Type:Organization
Organization Name:NOVO LIFE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:ALISE
Authorized Official - Last Name:KONZELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:206-659-5665
Mailing Address - Street 1:10512 NE 68TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7062
Mailing Address - Country:US
Mailing Address - Phone:206-659-5665
Mailing Address - Fax:
Practice Address - Street 1:10512 NE 68TH ST STE 101
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7062
Practice Address - Country:US
Practice Address - Phone:206-659-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center