Provider Demographics
NPI:1144996356
Name:OF LIFE PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:OF LIFE PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:REXROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-698-2087
Mailing Address - Street 1:100 OVERLOOK CTR STE 200
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7814
Mailing Address - Country:US
Mailing Address - Phone:609-273-5461
Mailing Address - Fax:954-987-4756
Practice Address - Street 1:100 OVERLOOK CTR STE 200
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7814
Practice Address - Country:US
Practice Address - Phone:609-273-5461
Practice Address - Fax:954-987-4756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty