Provider Demographics
NPI:1184241085
Name:LIFE ADVENTURES COUNSELING & CONSULTING, LLC
Entity type:Organization
Organization Name:LIFE ADVENTURES COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MAUREEN
Authorized Official - Last Name:LUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-481-4577
Mailing Address - Street 1:8588 STARKEY RD STE E
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-2831
Mailing Address - Country:US
Mailing Address - Phone:727-481-4577
Mailing Address - Fax:727-498-5698
Practice Address - Street 1:8588 STARKEY RD STE E
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-2831
Practice Address - Country:US
Practice Address - Phone:727-481-4577
Practice Address - Fax:727-498-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)