Provider Demographics
NPI:1295295970
Name:LIFE SOLUTIONS COUNSELING AND FAMILY THERAPY PLLC
Entity type:Organization
Organization Name:LIFE SOLUTIONS COUNSELING AND FAMILY THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:JARDINE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT-S, LPC, NCC
Authorized Official - Phone:318-355-6208
Mailing Address - Street 1:2001 ROSS AVE STE 700-111
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2911
Mailing Address - Country:US
Mailing Address - Phone:469-906-6093
Mailing Address - Fax:
Practice Address - Street 1:2001 ROSS AVE STE 700-111
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-2911
Practice Address - Country:US
Practice Address - Phone:469-906-6093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty