LIFESONG FOR GROWTH AND WELLNESS LLC (NPI# 1114228335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114228335 |
| Entity Type | Organization |
| Organization Name | LIFESONG FOR GROWTH AND WELLNESS LLC |
| Practice Address |
3401 W Truman Blvd Ste 100 Jefferson City MO 65109-5752 |
| Practice Telephone | 5736447909 |
| Practice Fax Number | 5736447908 |
| Mailing Telephone | 5736447909 |
| Mailing Fax Number | 5736447908 |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2014-05-02 |
| Authorized Official Name | MRS. DEBORAH MIDDLETON (PARTNER) |
| Authorized Official Telephone | 5736447909 |
| Authorized Official Credential | MA, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Street Address |
3401 W TRUMAN BLVD STE 100 |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-5752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508303538 | Health Remedies Wellness Counseling, LLC | Clinic/Center | 3401 W Truman Blvd, 204, Jefferson City, MO 65109-5752 | 2017-01-29 |
| 1871030809 | Kathleen Brandt-kessler | Counselor | 3401 W Truman Blvd, Jefferson City, MO 65109-5752 | 2017-01-29 |
| 1700234556 | Janice Orr | Counselor | 3401 W Truman Blvd, Suite 100, Jefferson City, MO 65109-5752 | 2016-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093170219 | Marissa R Abbott | Counselor | 919 Wildwood Dr, Suite 104, Jefferson City, MO 65109-5798 | 2015-12-15 |
| 1043647605 | Gail R Black | Counselor | 2202 Marilyn Dr, Jefferson City, MO 65109-0929 | 2013-09-27 |
| 1649617556 | Carl Adams Adams | Counselor | 1803 Sun Valley Dr, Suite B, Jefferson City, MO 65109-2178 | 2013-05-31 |
| 1891048799 | James Marion Smith | Counselor | 936 Sardonyx Dr, Jefferson City, MO 65109-6852 | 2012-10-17 |
| 1154602266 | Roger Dale Whittler | Counselor | 312 W Dunklin St, Jefferson City, MO 65101-1617 | 2011-09-01 |
| 1851679823 | Alexa Lynn Thompson | Counselor | 1409 Rehagen Blvd, Jefferson City, MO 65101-3736 | 2011-07-25 |
| 1275821860 | Sandra Mcdonald | Counselor | 1110 Missouri Blvd, Jefferson City, MO 65109-1722 | 2011-07-15 |
| 1053569004 | Maria C. Stokes | Counselor | 1110 Peyton Dr, Jefferson City, MO 65101-3769 | 2008-09-03 |
| 1881894392 | Donna Marie Adams | Counselor | 1026 Northeast Dr Ste B, Jefferson City, MO 65109-2517 | 2007-07-23 |
| 1356471734 | Elizabeth L Strolberg Page | Counselor | 415 E Mccarty St, Jefferson City, MO 65101 | 2007-03-06 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on LIFESONG FOR GROWTH AND WELLNESS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.