Provider Demographics
NPI:1790446441
Name:WHOLE LIFE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:WHOLE LIFE SOLUTIONS, LLC
Other - Org Name:WHOLE LIFE COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:270-535-6764
Mailing Address - Street 1:270 MICHAEL AVE SW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-7388
Mailing Address - Country:US
Mailing Address - Phone:270-535-6764
Mailing Address - Fax:505-657-5666
Practice Address - Street 1:270 MICHAEL AVE SW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-7388
Practice Address - Country:US
Practice Address - Phone:270-535-6764
Practice Address - Fax:505-657-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100537270Medicaid