Life Intervention Network Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIFE INTERVENTION NETWORK CENTER

Practice address

2551 River Forest CT
Ellenwood, GA 30294-1270

Phone

(850) 264-5745

NPI assigned

Mar 31, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Kelvin Brown

Title

Mental Health/Substance Abuse Couns

Phone

(850) 264-5745

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1588059232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360975",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300360975",
            "telephone_number": "850-264-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 RIVER FOREST CT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941270",
            "telephone_number": "850-264-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE INTERVENTION NETWORK CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KELVIN",
        "authorized_official_title_or_position": "MENTAL HEALTH/SUBSTANCE ABUSE COUNS",
        "authorized_official_telephone_number": "850-264-5745",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dornel J Lewis, NURSE PRACTITIONER
• Jacqueline Lewis, NP
• Kevin J Lewis, RT
• Mani Lewis
• Jacquiece Liddell, AGACNP
• Life Wellness Group of Atlanta
• Lillian Davenport Parker
• Tracy Lin, MS, OTR/L
• Wilbur T. Little
• Love Is Kind Counseling Services, LLC

• Mental Health Counselor in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.