Provider Demographics
NPI:1861669111
Name:LIFE SKILLS COUNSELING, INC.
Entity Type:Organization
Organization Name:LIFE SKILLS COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:623-974-9504
Mailing Address - Street 1:16901 N BOSWELL BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1294
Mailing Address - Country:US
Mailing Address - Phone:623-974-9504
Mailing Address - Fax:623-974-9505
Practice Address - Street 1:16901 N BOSWELL BLVD STE B
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1294
Practice Address - Country:US
Practice Address - Phone:623-974-9504
Practice Address - Fax:623-974-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10841251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health