Provider Demographics
NPI:1396171823
Name:LIFE'S JOURNEY COUNSELING, LLC
Entity type:Organization
Organization Name:LIFE'S JOURNEY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLAYER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-733-4422
Mailing Address - Street 1:266 MAIN ST
Mailing Address - Street 2:BUILDING ONE SUITE SEVEN
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2043
Mailing Address - Country:US
Mailing Address - Phone:508-733-4422
Mailing Address - Fax:
Practice Address - Street 1:266 MAIN ST
Practice Address - Street 2:BUILDING ONE SUITE SEVEN
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2043
Practice Address - Country:US
Practice Address - Phone:508-733-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1147761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty