Life Restore Counseling & Training, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIFE RESTORE COUNSELING & TRAINING, LLC

Practice address

2223 Old Minden Rd Ste C3
Bossier City, LA 71112-2303

Phone

(318) 573-2133

NPI assigned

May 13, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Gregory Gingles, LPC

Title

Licensed Professional Counselor

Phone

(318) 573-2133

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1053977348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 OLD MINDEN RD STE C3",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122303",
            "telephone_number": "318-573-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 OLD MINDEN RD STE C3",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122303",
            "telephone_number": "318-573-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RESTORE COUNSELING & TRAINING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "GINGLES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "318-573-2133",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.