Provider Demographics
NPI:1588954994
Name:COUNSELING FOR LIFE, INC.
Entity type:Organization
Organization Name:COUNSELING FOR LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOMBERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-353-3384
Mailing Address - Street 1:4123 OLD PORTMAN RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29626-5346
Mailing Address - Country:US
Mailing Address - Phone:864-353-3384
Mailing Address - Fax:
Practice Address - Street 1:125 MUDDY TOES DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29626-5349
Practice Address - Country:US
Practice Address - Phone:864-353-3384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5163101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty