Basic Information
Provider Information
NPI: 1629471628
EntityType: 2
ReplacementNPI:  
OrganizationName: LIFE & WELLNESS COUNSELING AND COUNSULTING
LastName:  
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Credential:  
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Mailing Information
Address1: 16507 NORTHCROSS DR STE A
Address2: SUITE 105
City: HUNTERSVILLE
State: NC
PostalCode: 280785082
CountryCode: US
TelephoneNumber: 7043058026
FaxNumber: 4256962262
Practice Location
Address1: 16507 NORTHCROSS DR STE A
Address2: SUITE 105
City: HUNTERSVILLE
State: NC
PostalCode: 280785082
CountryCode: US
TelephoneNumber: 7043058026
FaxNumber: 4256962262
Other Information
ProviderEnumerationDate: 10/03/2014
LastUpdateDate: 06/29/2016
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: COOPER
AuthorizedOfficialFirstName: ALLEGRA
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AuthorizedOfficialTitleorPosition: CO-OWNER
AuthorizedOfficialTelephone: 7043058026
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MA, LPCA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XA9259NCY193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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