Provider Demographics
NPI:1851694590
Name:LIFESKILLS COUNSELING SERVICES
Entity type:Organization
Organization Name:LIFESKILLS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KUGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:770-722-8156
Mailing Address - Street 1:2990 FORBES TRL
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-5933
Mailing Address - Country:US
Mailing Address - Phone:770-722-8156
Mailing Address - Fax:
Practice Address - Street 1:290 CONSTITUTION BLVD
Practice Address - Street 2:D
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-5696
Practice Address - Country:US
Practice Address - Phone:770-722-8156
Practice Address - Fax:678-985-3676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA916251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health