Provider Demographics
NPI:1942669379
Name:LIFE SOLUTIONS CONSULTING, LLC
Entity type:Organization
Organization Name:LIFE SOLUTIONS CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMERILLA
Authorized Official - Middle Name:B
Authorized Official - Last Name:FYFFE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:704-773-5329
Mailing Address - Street 1:610 E 7TH ST # 3A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2923
Mailing Address - Country:US
Mailing Address - Phone:704-773-5329
Mailing Address - Fax:
Practice Address - Street 1:610 E 7TH ST # 3A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2923
Practice Address - Country:US
Practice Address - Phone:704-773-5329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-1610101YA0400X
101YM0800X
NCC0020691041C0700X
NC9406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty