Provider Demographics
NPI:1417779802
Name:MY LIFE COUNSEL INC
Entity type:Organization
Organization Name:MY LIFE COUNSEL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-671-6790
Mailing Address - Street 1:5671 SW 35TH LN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9444
Mailing Address - Country:US
Mailing Address - Phone:352-234-8358
Mailing Address - Fax:352-570-9318
Practice Address - Street 1:5671 SW 35TH LN
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9444
Practice Address - Country:US
Practice Address - Phone:352-234-8358
Practice Address - Fax:352-570-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty