Provider Demographics
NPI:1023811080
Name:LIFE COACHING AND CONSULTING SERVICES
Entity type:Organization
Organization Name:LIFE COACHING AND CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:CRISTINA
Authorized Official - Last Name:GERACI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-610-9999
Mailing Address - Street 1:19 TAMARI CT
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-1828
Mailing Address - Country:US
Mailing Address - Phone:516-610-9999
Mailing Address - Fax:
Practice Address - Street 1:151 STATE ROUTE 10 E STE 201
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1452
Practice Address - Country:US
Practice Address - Phone:862-243-0512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY024884OtherLICENSE NUMBER
NJ35SI00662700OtherLICENSE NUMBER