Lifespan Counseling at the Kids Couch Inc LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC-0000362 Issued in DE

Legal business name

LIFESPAN COUNSELING AT THE KIDS COUCH INC LLC

Practice address

5700 Kirkwood Hwy
Suite 203
Wilmington, DE 19808-4857

Phone

(302) 384-8222

Fax

(302) 407-6698

NPI assigned

Jan 10, 2017

Organization subpart

No

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

Authorized official

Name

Olga Yatzus, LPCMH

Title

Executive Director

Phone

(302) 384-8222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1710423041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 KIRKWOOD HWY",
            "address_2": "SUITE 203",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084857",
            "telephone_number": "302-384-8222",
            "fax_number": "302-407-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 KIRKWOOD HWY",
            "address_2": "SUITE 203",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084857",
            "telephone_number": "302-384-8222",
            "fax_number": "302-407-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN COUNSELING AT THE KIDS COUCH INC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "YATZUS",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "302-384-8222",
        "authorized_official_credential": "LPCMH"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "PC-0000362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.