Living Life, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH5873 Issued in FL

Legal business name

LIVING LIFE, LLC

Practice address

2762 Dora Avenue
Suite 2762
Tavares, FL 32778-4970

Phone

(352) 253-1100

Fax

(352) 253-6241

NPI assigned

Aug 21, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Pamela D Duvall, M.S.

Title

Owner

Phone

(352) 253-1100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1154514354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 DORA AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784970",
            "telephone_number": "352-253-1100",
            "fax_number": "352-253-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2762 DORA AVENUE",
            "address_2": "SUITE 2762",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784970",
            "telephone_number": "352-253-1100",
            "fax_number": "352-253-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-253-1100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH5873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Tavares, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.