Provider Demographics
NPI:1427820307
Name:LIFE CHOICES COUNSELING & COACHING, PLLC
Entity type:Organization
Organization Name:LIFE CHOICES COUNSELING & COACHING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BROOOKE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-755-2122
Mailing Address - Street 1:5691 S REDWOOD RD UNIT 16
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5485
Mailing Address - Country:US
Mailing Address - Phone:801-755-2122
Mailing Address - Fax:
Practice Address - Street 1:5691 S REDWOOD RD UNIT 16
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5485
Practice Address - Country:US
Practice Address - Phone:801-755-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty