Provider Demographics
NPI:1710736228
Name:LIFE CENTERED THERAPY LLC
Entity type:Organization
Organization Name:LIFE CENTERED THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:781-891-7448
Mailing Address - Street 1:115 WORCESTER LN
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-7538
Mailing Address - Country:US
Mailing Address - Phone:781-891-7448
Mailing Address - Fax:
Practice Address - Street 1:115 WORCESTER LN
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-7538
Practice Address - Country:US
Practice Address - Phone:781-891-7448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty