Provider Demographics
NPI:1023445251
Name:LIVING WORD OF GOD MINISTRIES, INC.
Entity type:Organization
Organization Name:LIVING WORD OF GOD MINISTRIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PASTORAL COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:T
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-515-1657
Mailing Address - Street 1:9900 ULMERTON RD
Mailing Address - Street 2:218
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-4302
Mailing Address - Country:US
Mailing Address - Phone:727-515-1657
Mailing Address - Fax:
Practice Address - Street 1:9900 ULMERTON RD
Practice Address - Street 2:218
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-4302
Practice Address - Country:US
Practice Address - Phone:727-515-1657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7349105 AC101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty