Lifegrowth Marriage and Family Center

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LIFEGROWTH MARRIAGE AND FAMILY CENTER

Doing business as

Lifegrowth Marriage and Family Center

Practice address

5 S Centre Ave
Leesport, PA 19533-8653

Phone

(484) 400-0445

NPI assigned

Jan 28, 2019

Organization subpart

No

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

Authorized official

Name

Giannina Katherine Reyes, LPC

Title

Clinical Director

Phone

(484) 400-0445

Specialties & licenses 1

Addresses

Other names 1

• Lifegrowth Marriage and Family Center Doing business as

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1770047359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 HAMPDEN BLVD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196041604",
            "telephone_number": "484-400-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S CENTRE AVE",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338653",
            "telephone_number": "484-400-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGROWTH MARRIAGE AND FAMILY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "GIANNINA",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "484-400-0445",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifegrowth Marriage and Family Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifegrowth Marriage and Family Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nina Elisabeth Kozar
• Kristina Kreiser, MA
• Veronica Lardani, CRNA
• David Alan Leader, D.C.
• Douglas Clarence Leder, D.O.
• Melanie Long
• Kenneth J. Lord, M.D.
• Casey Madtes
• Timothy John Makatche, DO
• Jeffrey David Marks, M.A.

• Professional Counselor in Leesport, PA
• Providers in Leesport, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.