LIFE SOURCE COUNSELING & CONSULTING, LLC (NPI# 1972123362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972123362 |
| Entity Type | Organization |
| Organization Name | LIFE SOURCE COUNSELING & CONSULTING, LLC |
| Practice Address |
118 North Avenue, Suite A Jonesboro GA 30236 |
| Mailing Address |
P.o. Box 302 Rex GA 30273-0302 |
| Practice Telephone | 4043728941 |
| Mailing Telephone | 4043728941 |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2020-04-25 |
| Authorized Official Name | DR. STEPHANE EVETTE WILLIAMS (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Telephone | 4043728941 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
118 NORTH AVENUE, SUITE A |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| 1184045163 | Diane Johnson | Community/Behavioral Health | 1141 Gable Terrace, Jonesboro, GA 30236 | 2013-12-18 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113650 | Secure Foundation Counseling Pllc | Clinic/Center | 125 N Fisher St, Jonesboro, AR 72401-2116 | 2020-10-31 |
| 1598398802 | Bhg L, LLC | Clinic/Center | 5510 Southwest Drive, Ste 8, Jonesboro, AR 72404-8352 | 2020-02-14 |
| 1548721525 | Essential Medical and Mental Health Institute | Clinic/Center | 486 Luke Ct, Jonesboro, GA 30238-5798 | 2019-03-30 |
| 1033682612 | Gr8-xpressions Behavioral Health, LLC. | Clinic/Center | 8762 Edenton Way, Jonesboro, GA 30238-4494 | 2019-01-07 |
| 1427416577 | Life Rediscovery Center, LLC | Clinic/Center | 522 Flint Trl, Ste A, Jonesboro, GA 30236-1316 | 2016-02-03 |
| 1639358906 | Clayton Mhddad | Clinic/Center | 1585 Pintail Rd, Jonesboro, GA 30238-6641 | 2007-11-02 |
| 1679761373 | Clayton Mhddad | Clinic/Center | 2081 Logan Dr, Jonesboro, GA 30236-7215 | 2007-10-09 |
| 1851589550 | Clayton Mhddad | Clinic/Center | 7814 Fielder Rd, Jonesboro, GA 30236-2610 | 2007-10-09 |
| 1497943104 | Clayton Mhddad | Clinic/Center | 901 Walnut Creek Ln, Jonesboro, GA 30238-6465 | 2007-10-09 |
| 1760670467 | Clayton Mhddad | Clinic/Center | 9698 Holly Hill Way, Jonesboro, GA 30238-6490 | 2007-10-09 |
| Find all providers in JONESBORO | ||||
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| 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.