NPIMap

Organization Active NPI

Lifewise Inc.

  • Professional Counselor
  • Louisville, KY
National Provider Identifier
1770037111
Registry record updated Aug 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0222 Issued in KY
Legal business name
LIFEWISE INC.
Practice address
2009 Glenview Ave
Louisville, KY 40222-6345
Phone
(502) 426-1616
Fax
(502) 290-8889
NPI assigned
Aug 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2016

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

Authorized official

Name
Dr. Jan Anderson, PSYD, LPCCNPI 1538909122
Title
President
Phone
(502) 426-1616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 0222 KY Primary

Addresses

Primary practice location

2009 Glenview Ave
Louisville, KY 40222-6345

Mailing address

2009 Glenview Ave
Louisville, KY 40222-6345
Phone (502) 426-1616

National Provider Directory

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": "1471132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471132800000",
    "number": "1770037111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 GLENVIEW AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226345",
            "telephone_number": "502-426-1616",
            "fax_number": "502-290-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 GLENVIEW AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226345",
            "telephone_number": "502-426-1616",
            "fax_number": "502-290-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWISE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-14",
        "last_updated": "2016-08-14",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-426-1616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "0222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2016; 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.