Provider Demographics
NPI:1982633673
Name:LIFECHANGING COUNSELING PA
Entity Type:Organization
Organization Name:LIFECHANGING COUNSELING PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:239-243-8098
Mailing Address - Street 1:6237 PRESIDENTIAL CT STE 110
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3508
Mailing Address - Country:US
Mailing Address - Phone:239-243-8098
Mailing Address - Fax:239-482-5335
Practice Address - Street 1:6237 PRESIDENTIAL CT STE 110
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3508
Practice Address - Country:US
Practice Address - Phone:239-243-8098
Practice Address - Fax:239-482-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003634101YM0800X
FLMH 11424101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty