Provider Demographics
NPI:1538876776
Name:LIVE WELL COUNSELING LLC
Entity type:Organization
Organization Name:LIVE WELL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-270-2617
Mailing Address - Street 1:174 NEWBURYPORT TPKE # 352
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-2014
Mailing Address - Country:US
Mailing Address - Phone:978-270-2617
Mailing Address - Fax:
Practice Address - Street 1:174 NEWBURYPORT TPKE # 352
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-2014
Practice Address - Country:US
Practice Address - Phone:978-270-2617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health