Provider Demographics
NPI:1992756605
Name:LIFEWORKS PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LIFEWORKS PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSW, LCSW
Authorized Official - Phone:828-433-9190
Mailing Address - Street 1:205 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3449
Mailing Address - Country:US
Mailing Address - Phone:828-433-9190
Mailing Address - Fax:828-433-9130
Practice Address - Street 1:205 E UNION ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3449
Practice Address - Country:US
Practice Address - Phone:828-433-9190
Practice Address - Fax:828-433-9130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005207Medicaid
NC2336776AMedicare ID - Type Unspecified