Life 360 Therapy Services, Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7173 Issued in NC

Legal business name

LIFE 360 THERAPY SERVICES, INC

Practice address

13721 Heritage Dr
Laurinburg, NC 28352-9185

Phone

(910) 206-8228

NPI assigned

Oct 30, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Rebecca Amber Crowe Russell, M.S. CCC-SLPNPI 1285893354

Title

President

Phone

(910) 206-8228

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Amber Crowe Russell, M.S. , CCC-SLP

  • Speech-Language Pathologist
  • Laurinburg, NC
  • NPI 1285893354
  NPD Authorized official

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1508238403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13721 HERITAGE DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283529185",
            "telephone_number": "910-206-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13721 HERITAGE DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283529185",
            "telephone_number": "910-206-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE 360 THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "AMBER CROWE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-206-8228",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285893354",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Douglas Leporte, DO
• Lets Breathe Counseling and Educational Services, LLC
• Heather Lewis, FNP-C
• Sisi Liang, DPM
• Liem & Lim Associates PC
• Life Balance Nutrition Services
• Marlee M Lockey, LPC
• Ashley Marie Locklear, PA-C
• Clyde Vance Locklear, LPC
• Crystal Gail Locklear, FNP

• Speech-Language Pathologist in Laurinburg, NC
• Providers in Laurinburg, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.