Life Dance Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LIFE DANCE INC

Practice address

6417 NW 37TH Dr
Gainesville, FL 32653-0868

Phone

(352) 335-1240

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Manuel, PSY.D.

Title

President

Phone

(352) 335-1240

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1104905348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6417 NW 37TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326530868",
            "telephone_number": "352-335-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 NW 37TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326530868",
            "telephone_number": "352-335-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE DANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-335-1240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Nicole Liebenow
• Leora Lieberman, MD
• Khon Han Lien
• Melissa Ann Lierse, MSW, LCSW
• Xin Yi Liew
• Life Force Health and Wellness LL
• Life Line Home Care Inc
• Lifestyle Wellness, LLC
• Jennifer K. Light, MD
• Carolyn V Lightner, ARNP

• Clinical Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.