Provider Demographics
NPI:1083994883
Name:LIFE WORKS KINSTON, PLLC
Entity type:Organization
Organization Name:LIFE WORKS KINSTON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:FREELAND
Authorized Official - Last Name:SPERATI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-389-0211
Mailing Address - Street 1:704C PLAZA BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1657
Mailing Address - Country:US
Mailing Address - Phone:252-208-1710
Mailing Address - Fax:252-208-0746
Practice Address - Street 1:704C PLAZA BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1657
Practice Address - Country:US
Practice Address - Phone:252-208-1710
Practice Address - Fax:252-208-0746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005984251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health