Provider Demographics
NPI:1558110718
Name:LIFEDESIGN THERAPY LLC
Entity type:Organization
Organization Name:LIFEDESIGN THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CAADC
Authorized Official - Phone:814-464-5895
Mailing Address - Street 1:3910 CAUGHEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4098
Mailing Address - Country:US
Mailing Address - Phone:814-464-5895
Mailing Address - Fax:
Practice Address - Street 1:3910 CAUGHEY RD STE 200
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4098
Practice Address - Country:US
Practice Address - Phone:814-464-5895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty