Provider Demographics
NPI:1316701121
Name:LIVING WELL COUNSELING, LLC
Entity type:Organization
Organization Name:LIVING WELL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CULBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:636-535-7472
Mailing Address - Street 1:104 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-3338
Mailing Address - Country:US
Mailing Address - Phone:636-209-2344
Mailing Address - Fax:888-474-0821
Practice Address - Street 1:12601 MISSOURI STATE RD 21
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-3315
Practice Address - Country:US
Practice Address - Phone:636-535-7472
Practice Address - Fax:888-474-0821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty