Provider Demographics
NPI:1487349304
Name:GOODLIFE COUNSELING LLC
Entity type:Organization
Organization Name:GOODLIFE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAIT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:864-643-9188
Mailing Address - Street 1:840 W RIVER GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:ROEBUCK
Mailing Address - State:SC
Mailing Address - Zip Code:29376-3942
Mailing Address - Country:US
Mailing Address - Phone:864-643-9188
Mailing Address - Fax:
Practice Address - Street 1:269 S CHURCH ST STE 217
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3483
Practice Address - Country:US
Practice Address - Phone:864-399-7312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty