LIFE PROVISIONS, LLC. (NPI# 1245773167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245773167 |
| Entity Type | Organization |
| Organization Name | LIFE PROVISIONS, LLC. |
| Practice Address |
2025 Ebenezer Rd Ste J4 Rock Hill SC 29732-1079 |
| Practice Telephone | 7043004273 |
| Mailing Telephone | 7043004273 |
| Enumeration Date | 2016-11-25 |
| Last Update Date | 2019-08-14 |
| Authorized Official Name | CASSANDRA DEMETRIA BELL (OWNER/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7043004273 |
| Authorized Official Credential | MED., LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 251E00000X | Home Health | Agencies | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 331 E Main St, Suite 200, Rock Hill, SC 297305383 | 7042975202 | |
| 105 W Cherokee St, Blacksburg, SC 297021501 | 8644923179 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Life Provisions, LLC | 545 Cr 175, Bayfield, CO 81122 |
| Street Address |
2025 EBENEZER RD STE J4 |
| City | ROCK HILL |
| State | SC |
| Zip Code | 29732-1079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790976165 | Cassandra Bell-gash | Counselor | 2025 Ebenezer Rd Ste J4, Rock Hill, SC 29732-1079 | 2007-08-09 |
| 1679116156 | Divine Purpose Services Limited LLC | Community/Behavioral Health | 2025 Ebenezer Rd Ste J4, Rock Hill, SC 29732-1079 | 2019-10-28 |
| 1902229586 | Sarah Atkinson | Dietitian, Registered | 2025 Ebenezer Rd Ste J4, Rock Hill, SC 29732-1079 | 2014-02-02 |
| 1174897391 | Divine Purpose Services Limited LLC | Psychiatry & Neurology | 2025 Ebenezer Rd Ste J4, Rock Hill, SC 29732-1079 | 2012-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023659471 | Jessie M. Armstrong | Counselor | 199 S Herlong Avenue, Rock Hill, SC 29732 | 2019-10-07 |
| 1215407861 | Alicia Johnson | Occupational Therapist | 2025 Ebenezer Rd Suite H, Rock Hill, SC 29732 | 2018-11-27 |
| 1346716909 | Leslie Marie Metzler | Nurse Practitioner | 125 Amendment Ave, Rock Hill, SC 29732 | 2018-10-22 |
| 1356824668 | Laurie E Grove | Counselor | 508 Bethel Street, Clover, SC 29732 | 2018-09-12 |
| 1366924441 | Chinyere Gill-smith | Occupational Therapist | 2390 127 Murrah Drive, Rock Hill, SC 29732 | 2018-09-05 |
| 1053825513 | Community Medicine Foundation Inc | Clinic/Center | 205 Piedmont Blvd. Suite 100, Catawba Community Mental Health Services York Adult Ser, Rock Hill, SC 29732 | 2017-11-20 |
| 1952824906 | Miriam George-norman | Occupational Therapist | 831 Mcdow Drive, Rock Hill, SC 29732 | 2017-07-21 |
| 1255854550 | Courtney Costa | Counselor | 199 S. Herlong Avenue, Rock Hill, NC 29732 | 2017-07-19 |
| 1861913022 | Drs Misiek, Farrell, Farrell, Nale, Cook, Kapitan, Mohamed & Franco Pa | Oral & Maxillofacial Surgery | 1761 Ebenezer Road, Rock Hill, SC 29732 | 2017-06-28 |
| 1396275806 | Chrysalis Autism Center, Inc | Assistant Behavior Analyst | 1547 Cherry Rd, Rock Hill, SC 29732 | 2017-06-16 |
| Find all providers in zip 29732 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484714 | Shira Simmons Culbreath | Counselor | 5124 Norway Ln, Rock Hill, SC 29732-8399 | 2020-10-12 |
| 1487277695 | Family Alliance Network LLC | Counselor | 331 E Main St Ste 212, Rock Hill, SC 29730-5384 | 2020-05-21 |
| 1578183745 | Michaela Mary Kelly | Counselor | 815 Willow Wood Ln Apt 104, Rock Hill, SC 29730-6692 | 2020-04-17 |
| 1386279693 | Joel Daniel Dean | Counselor | 845 Willow Wood Ln Apt 106, Rock Hill, SC 29730-0122 | 2020-03-06 |
| 1144853607 | Tiffani Coleman | Counselor | 454 Anderson Rd S Ste 326, Rock Hill, SC 29730-3398 | 2020-02-12 |
| 1710527023 | Darlene Strickland | Counselor | 454 Anderson Rd S Ste 217, Rock Hill, SC 29730-3398 | 2020-01-14 |
| 1285272104 | Amy C.l. Kulbok | Counselor | 146 E White St Ste E, Rock Hill, SC 29730-4526 | 2019-12-11 |
| 1740831197 | E and S Cares | Counselor | 454 Anderson Rd S Ste 180, Rock Hill, SC 29730-3398 | 2019-09-26 |
| 1245881689 | Ah Cares | Counselor | 454 Anderson Rd S Ste 240, Rock Hill, SC 29730-3398 | 2019-09-26 |
| 1598312969 | Erinnae Cline | Counselor | 864 Springdale Road, Rock Hill, SC 29730 | 2019-08-21 |
| Find all providers in ROCK HILL | ||||
Please comment or provide details below to improve the information on LIFE PROVISIONS, 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.