Lifemor Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0083441 Issued in NM

Legal business name

LIFEMOR INC.

Practice address

875 S Estrella Pkwy Unit 6573
Goodyear, AZ 85338-8563

Phone

(480) 370-0227

Fax

(505) 814-5740

NPI assigned

Jan 10, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Robert Grant Gates, M.A. LPCC. DMIN

Title

President

Phone

(480) 370-0227

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1710224779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 S ESTRELLA PKWY UNIT 6573",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853388563",
            "telephone_number": "480-370-0227",
            "fax_number": "505-814-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S ESTRELLA PKWY UNIT 6573",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853388563",
            "telephone_number": "480-370-0227",
            "fax_number": "505-814-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEMOR INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-370-0227",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A.  LPCC. DMIN"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0083441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Goodyear, AZ
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• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.