Provider Demographics
NPI:1225594542
Name:LIFE SOLUTIONS COUNSELING AGENCY LLC
Entity type:Organization
Organization Name:LIFE SOLUTIONS COUNSELING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FAYIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SICARR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-761-9277
Mailing Address - Street 1:6003 N ROBINSON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-7425
Mailing Address - Country:US
Mailing Address - Phone:405-810-2922
Mailing Address - Fax:405-810-2922
Practice Address - Street 1:6003 N ROBINSON AVE STE 102
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-7425
Practice Address - Country:US
Practice Address - Phone:405-810-2922
Practice Address - Fax:405-810-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health