Life Provisions, LLC.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIFE PROVISIONS, LLC.

Practice address

2025 Ebenezer Rd Ste J4
Rock Hill, SC 29732-1079

Phone

(704) 300-4273

NPI assigned

Nov 25, 2016

Organization subpart

No

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

Authorized official

Name

Cassandra Demetria Bell, MED., LPC

Title

Owner/Chief Executive Officer

Phone

(704) 300-4273

Specialties & licenses 4

Addresses

Tax ID family

Life Provisions LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Life Provisions, LLC

  • Community/Behavioral Health Agency
  • Gaffney, SC
  • NPI 1982086708
  NPD tax ID
• Life Provisions, LLC

  • Community/Behavioral Health Agency
  • Shelby, NC
  • NPI 1831578772
  NPD tax ID

Locations

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

{
    "created_epoch": "1480032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1245773167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 EBENEZER RD STE J4",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321079",
            "telephone_number": "704-300-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 EBENEZER RD STE J4",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321079",
            "telephone_number": "704-300-4273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 E Main St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297305383",
            "country_code": "US",
            "telephone_number": "704-297-5202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 W Cherokee St",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "SC",
            "postal_code": "297021501",
            "country_code": "US",
            "telephone_number": "864-492-3179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE PROVISIONS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-25",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "DEMETRIA",
        "authorized_official_title_or_position": "OWNER/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "704-300-4273",
        "authorized_official_credential": "MED., LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.