NPIMap

Organization Active NPI

Lifesong for Growth and Wellness LLC

  • Professional Counselor
  • Jefferson City, MO
National Provider Identifier
1114228335
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LIFESONG FOR GROWTH AND WELLNESS LLC
Practice address
3401 W Truman Blvd
Ste 100
Jefferson City, MO 65109-5752
Phone
(573) 644-7909
Fax
(573) 644-7908
NPI assigned
Nov 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Authorized official

Name
Mrs. Deborah Middleton, MA, LCSW
Title
Partner
Phone
(573) 644-7909

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

3401 W Truman Blvd
Ste 100
Jefferson City, MO 65109-5752

Mailing address

3401 W Truman Blvd
Ste 100
Jefferson City, MO 65109-5752
Phone (573) 644-7909

National Provider Directory

National Provider Directory

Locations

3405 W Truman Blvd
Ste 101
Jefferson City, MO 65109
Phone (573) 864-7868

3401 W Truman Blvd
Ste 100
Jefferson Cty, MO 65109
Phone (573) 644-7909

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1114228335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W TRUMAN BLVD",
            "address_2": "STE 100",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095752",
            "telephone_number": "573-644-7909",
            "fax_number": "573-644-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W TRUMAN BLVD",
            "address_2": "STE 100",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095752",
            "telephone_number": "573-644-7909",
            "fax_number": "573-644-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESONG FOR GROWTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "573-644-7909",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.