Provider Demographics
NPI:1457070450
Name:LIFEPROOF COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:LIFEPROOF COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LCDC
Authorized Official - Phone:210-850-1157
Mailing Address - Street 1:14223 N HILLS VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2564
Mailing Address - Country:US
Mailing Address - Phone:210-850-1157
Mailing Address - Fax:
Practice Address - Street 1:6326 SOVEREIGN ST STE 238
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5130
Practice Address - Country:US
Practice Address - Phone:726-336-9390
Practice Address - Fax:726-336-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health