Life Abundant Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3483 Issued in KY

Legal business name

LIFE ABUNDANT CENTER

Practice address

1830 Destiny LN
Suite105
Bowling Green, KY 42104-1087

Phone

(270) 792-9683

NPI assigned

Jul 25, 2016

Organization subpart

No

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

Authorized official

Name

Jamie Elizabeth Wall, LCSW

Title

Owner

Phone

(270) 792-9683

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie Elizabeth Cole, LCSW

  • Clinical Social Worker
  • Bowling Green, KY
  • NPI 1073812343
  NPD (past)

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1063965242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 DESTINY LN",
            "address_2": "SUITE105",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 DESTINY LN",
            "address_2": "SUITE105",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041087",
            "telephone_number": "270-792-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ABUNDANT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-792-9683",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Lewis, APRN
• William Fielding Lewis, MD
• LHC, LLC
• Evelyn Libe, LCSW
• Tebogo T Libe
• Lifeline Health Care of Kentucky, Inc.
• Lifeline Home Health Care of Bowling Green, LLC
• Lifeskills
• Lifeskills, Inc
• Lifeskills, Inc.

• Clinical Social Worker in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.