Provider Demographics
NPI:1982161915
Name:LIFE LINE COUNSELING INC
Entity Type:Organization
Organization Name:LIFE LINE COUNSELING INC
Other - Org Name:LIFE LINE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:P
Authorized Official - Last Name:RASNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA,
Authorized Official - Phone:727-201-2577
Mailing Address - Street 1:11020 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3229
Mailing Address - Country:US
Mailing Address - Phone:727-201-2577
Mailing Address - Fax:
Practice Address - Street 1:11020 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-3229
Practice Address - Country:US
Practice Address - Phone:727-201-2577
Practice Address - Fax:407-289-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty