Provider Demographics
NPI:1396936456
Name:LIFE STAGES COUNSELING
Entity type:Organization
Organization Name:LIFE STAGES COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:956-200-7884
Mailing Address - Street 1:PO BOX 1462
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78551-1462
Mailing Address - Country:US
Mailing Address - Phone:956-200-7884
Mailing Address - Fax:956-412-2404
Practice Address - Street 1:2407 HAINE DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8592
Practice Address - Country:US
Practice Address - Phone:956-200-7884
Practice Address - Fax:956-412-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60413251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health