Provider Demographics
NPI:1336963313
Name:LIFETREE COUNSELING
Entity type:Organization
Organization Name:LIFETREE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:C
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:859-559-8002
Mailing Address - Street 1:121 WANNAMAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8037
Mailing Address - Country:US
Mailing Address - Phone:859-559-8002
Mailing Address - Fax:
Practice Address - Street 1:121 WANNAMAKER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8037
Practice Address - Country:US
Practice Address - Phone:859-559-8002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty