NPIMap

Organization Active NPI

Life Counseling Center PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clyde, NC
National Provider Identifier
1376738716
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
MHL-044-042 Issued in NC
Legal business name
LIFE COUNSELING CENTER PA
Practice address
124 Life Way
Clyde, NC 28721-6540
Phone
(828) 627-5433
Fax
(828) 627-8888
NPI assigned
Sep 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Authorized official

Name
Mr. Nathan Haas
Title
Business Administrator
Phone
(828) 627-5433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MHL-044-042 NC Primary

Addresses

Primary practice location

124 Life Way
Clyde, NC 28721-6540

Mailing address

124 Life Way
Clyde, NC 28721-6540

Other identifiers 1

IdentifierTypeStateIssuer
8300647GMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Life Counseling Center PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1376738716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 LIFE WAY",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287216540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 LIFE WAY",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287216540",
            "telephone_number": "828-627-5433",
            "fax_number": "828-627-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE COUNSELING CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "HAAS",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "828-627-5433",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "MHL-044-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300647G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.