Provider Demographics
NPI:1104275395
Name:MY LIFE MATTERS,LLC
Entity type:Organization
Organization Name:MY LIFE MATTERS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-847-1818
Mailing Address - Street 1:900 GREENVILLE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILLIAMSTON
Mailing Address - State:SC
Mailing Address - Zip Code:29697-1130
Mailing Address - Country:US
Mailing Address - Phone:864-847-1818
Mailing Address - Fax:864-847-5706
Practice Address - Street 1:900 GREENVILLE DR
Practice Address - Street 2:SUITE B
Practice Address - City:WILLIAMSTON
Practice Address - State:SC
Practice Address - Zip Code:29697-1130
Practice Address - Country:US
Practice Address - Phone:864-847-1818
Practice Address - Fax:864-847-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1634101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP6307Medicaid