Provider Demographics
NPI:1821534405
Name:LIFEWAY COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:LIFEWAY COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:940-382-0109
Mailing Address - Street 1:PO BOX 50084
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76206-0084
Mailing Address - Country:US
Mailing Address - Phone:940-382-0109
Mailing Address - Fax:940-382-0482
Practice Address - Street 1:9300 JOHN HICKMAN PKWY
Practice Address - Street 2:SUITE 605
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5711
Practice Address - Country:US
Practice Address - Phone:940-382-0109
Practice Address - Fax:940-382-0482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17396101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty