Provider Demographics
NPI:1851800437
Name:THE GOOD LIFE INSTITUTE, LLC
Entity Type:Organization
Organization Name:THE GOOD LIFE INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARIAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:253-238-6554
Mailing Address - Street 1:1033 REGENTS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6089
Mailing Address - Country:US
Mailing Address - Phone:253-238-6554
Mailing Address - Fax:253-590-0821
Practice Address - Street 1:1033 REGENTS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6089
Practice Address - Country:US
Practice Address - Phone:253-238-6554
Practice Address - Fax:253-590-0821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60200313101YM0800X
WALF60123442106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1316128523OtherNPI
WA1649450313OtherNPI