Provider Demographics
NPI:1750973111
Name:LIVE WELL COUNSELING & CONSULTING, LLC
Entity type:Organization
Organization Name:LIVE WELL COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, CSAC
Authorized Official - Phone:434-603-1982
Mailing Address - Street 1:3235 ELECTRIC RD STE 2B-1
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0191
Mailing Address - Country:US
Mailing Address - Phone:434-603-1982
Mailing Address - Fax:855-514-2805
Practice Address - Street 1:3235 ELECTRIC RD STE 2B-1
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0191
Practice Address - Country:US
Practice Address - Phone:434-603-1982
Practice Address - Fax:855-514-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty