Life Poured Out Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIFE POURED OUT SERVICES, INC.

Doing business as

Life Poured Out Services, Inc.

Practice address

3595 Hiram Douglasville Hwy Ste 108
Hiram, GA 30141-4963

Phone

(770) 635-7847

Fax

(910) 516-1336

NPI assigned

Feb 8, 2021

Last updated

Dec 8, 2021By 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

Mrs. Suzett Delicia Blount, LPC

Title

Therapist/Co-Founder

Phone

(718) 644-4998

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Life Poured Out Services, Inc. Doing business as

Electronic endpoints 2

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.

• Suzette Delicia Williams, LPC

  • Professional Counselor
  • Dallas, GA
  • NPI 1942823901
  NPD

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1174115539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 HIRAM DOUGLASVILLE HWY STE 108",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301414963",
            "telephone_number": "770-635-7847",
            "fax_number": "910-516-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 HIRAM DOUGLASVILLE HWY STE 108",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301414963",
            "telephone_number": "770-635-7847",
            "fax_number": "910-516-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE POURED OUT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "BLOUNT",
        "authorized_official_first_name": "SUZETT",
        "authorized_official_middle_name": "DELICIA",
        "authorized_official_title_or_position": "THERAPIST/CO-FOUNDER",
        "authorized_official_telephone_number": "718-644-4998",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL",
            "identifier": "LPC011523",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.lposervices.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3595 Hiram Douglasville Hwy Ste 108",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301414963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "suzettb@lposervices.org",
            "affiliation": "Y",
            "endpointDescription": "e-mail address",
            "affiliationName": "Boundless Love Psychotherapy, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3595 Hiram Douglasville Hwy Ste 108",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301414963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Poured Out Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Hiram, GA
• Providers in Hiram, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.