Life Recreated PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

LIFE RECREATED PLLC

Practice address

825 3Rd Ave NW Ste 2
Hickory, NC 28601-4806

Phone

(704) 975-0691

NPI assigned

Jun 19, 2023

Last updated

Jun 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Queen

Title

Business Manager

Phone

(704) 975-0691

Specialties & licenses 5

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Brenton Queen, MS, LMFT, LCAS

  • Marriage & Family Therapist
  • Hickory, NC
  • NPI 1548330905
  NPD

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1154006104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 3RD AVE NW STE 2",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286014806",
            "telephone_number": "704-975-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 3RD AVE NW STE 2",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286014806",
            "telephone_number": "704-975-0691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Grouse Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "NC",
            "postal_code": "287865190",
            "country_code": "US",
            "telephone_number": "704-975-0691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE RECREATED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "QUEEN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "704-975-0691"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Ann McKenna, PLLC
• Beverlee A Leslie, LPC
• Karen Joyce Lessaris, MD
• Kenneth Allan Levesque, PMHNP-BC
• Karen Celeste Lewis, NURSE PRACTITIONER
• Lifecycles LLC
• Wallace S Liggett IV, PA-C
• Sarah Lightfoot
• Like a Breeze Tribe Express LLC
• Nina Dantzler Lillard, PMHCNS-BC

• Marriage & Family Therapist in Hickory, NC
• Providers in Hickory, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.