Provider Demographics
NPI:1669711479
Name:LIFECARE CHRISTIAN COUNSELING INC
Entity type:Organization
Organization Name:LIFECARE CHRISTIAN COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CARFIZZI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-933-4745
Mailing Address - Street 1:739 ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-8908
Mailing Address - Country:US
Mailing Address - Phone:404-933-4745
Mailing Address - Fax:
Practice Address - Street 1:107 W COURTHOUSE SQ
Practice Address - Street 2:SUITE 279
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1610
Practice Address - Country:US
Practice Address - Phone:404-933-4745
Practice Address - Fax:678-281-0645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty