Provider Demographics
NPI:1811490964
Name:LIFEWORKS RESOURCES, LLC
Entity type:Organization
Organization Name:LIFEWORKS RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:731-467-0504
Mailing Address - Street 1:1186 HWY 45 BYPASS STE D
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3256
Mailing Address - Country:US
Mailing Address - Phone:317-215-0502
Mailing Address - Fax:731-345-4086
Practice Address - Street 1:1186 HWY 45 BYPASS STE D
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3256
Practice Address - Country:US
Practice Address - Phone:731-215-0502
Practice Address - Fax:731-345-4086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ035248.Medicaid