Provider Demographics
NPI:1770718033
Name:LIFE STRATEGY CENTER
Entity type:Organization
Organization Name:LIFE STRATEGY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:307-674-8686
Mailing Address - Street 1:PO BOX 7035
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-7001
Mailing Address - Country:US
Mailing Address - Phone:307-674-8686
Mailing Address - Fax:307-674-1825
Practice Address - Street 1:1949 SUGARLAND DR
Practice Address - Street 2:SUITE 218
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5755
Practice Address - Country:US
Practice Address - Phone:307-674-8686
Practice Address - Fax:307-674-1825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY424101YP2500X
WY552101YP2500X
WY403103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty