Provider Demographics
NPI:1174276372
Name:LIFEPATH COUNSELING & THERAPY SERVICES LLC
Entity type:Organization
Organization Name:LIFEPATH COUNSELING & THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-849-1760
Mailing Address - Street 1:120 MADEIRA DR NE STE 220
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1538
Mailing Address - Country:US
Mailing Address - Phone:360-849-1760
Mailing Address - Fax:866-892-3005
Practice Address - Street 1:120 MADEIRA DR NE STE 220
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1538
Practice Address - Country:US
Practice Address - Phone:360-849-1760
Practice Address - Fax:866-892-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty