Provider Demographics
NPI:1174067417
Name:THE LIFESKILLS COUNSELING & CONSULTING GROUP
Entity type:Organization
Organization Name:THE LIFESKILLS COUNSELING & CONSULTING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LPCS,LCAS
Authorized Official - Phone:704-548-5299
Mailing Address - Street 1:1300 MATTHEWS-MINT HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105
Mailing Address - Country:US
Mailing Address - Phone:704-548-5299
Mailing Address - Fax:704-548-5292
Practice Address - Street 1:1300 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2306
Practice Address - Country:US
Practice Address - Phone:704-847-0021
Practice Address - Fax:704-548-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12553251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health