Provider Demographics
NPI:1932497617
Name:LIFE COACH PSYCHOLOGY PLC
Entity Type:Organization
Organization Name:LIFE COACH PSYCHOLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:907-330-9669
Mailing Address - Street 1:3105 LAKESHORE DR
Mailing Address - Street 2:SUITE B102
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-2806
Mailing Address - Country:US
Mailing Address - Phone:907-330-9669
Mailing Address - Fax:
Practice Address - Street 1:3105 LAKESHORE DR
Practice Address - Street 2:SUITE B102
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2806
Practice Address - Country:US
Practice Address - Phone:907-330-9669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK609103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty