Lifestyle Overhaul, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIFESTYLE OVERHAUL, LLC

Practice address

98 E Lake Mead Pkwy Ste 201
Henderson, NV 89015-6443

Phone

(702) 433-3038

NPI assigned

Jan 24, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Claudia Johnson, LCPC

Title

Professional Clinical Counselor

Phone

(708) 752-3361

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1821628199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 E LAKE MEAD PKWY STE 201",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890156443",
            "telephone_number": "702-433-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 E LAKE MEAD PKWY STE 201",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890156443",
            "telephone_number": "702-433-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE OVERHAUL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_title_or_position": "PROFESSIONAL CLINICAL COUNSELOR",
        "authorized_official_telephone_number": "708-752-3361",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Apr 21, 2021; 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.