Provider Demographics
NPI:1932359320
Name:LIFE FOCUS PSYCHOLOGICAL CONSULTING SERVICES
Entity Type:Organization
Organization Name:LIFE FOCUS PSYCHOLOGICAL CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:812-299-5919
Mailing Address - Street 1:1624 E SPRINGHILL DR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4363
Mailing Address - Country:US
Mailing Address - Phone:812-299-5919
Mailing Address - Fax:812-299-3263
Practice Address - Street 1:1624 E SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4363
Practice Address - Country:US
Practice Address - Phone:812-299-5919
Practice Address - Fax:812-299-3263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040585A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty