Provider Demographics
NPI:1750539516
Name:LIFECARE COUNSELING AND COACHING, INC
Entity type:Organization
Organization Name:LIFECARE COUNSELING AND COACHING, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:LANKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MACC, MBA, MDIV, LPC
Authorized Official - Phone:919-851-1527
Mailing Address - Street 1:1601 JONES FRANKLIN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3379
Mailing Address - Country:US
Mailing Address - Phone:919-851-1527
Mailing Address - Fax:919-851-3555
Practice Address - Street 1:1601 JONES FRANKLIN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3379
Practice Address - Country:US
Practice Address - Phone:919-851-1527
Practice Address - Fax:919-851-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP1600X, 1041C0700X
NC106H00000X
NC6654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty