| Authentic Life LLC | |
|
4228 S Hocker Dr Bldg 12 Independence MO 64055-4754 | |
| (816) 381-7690 | |
| (816) 381-4356 |
| Full Name | Authentic Life LLC |
|---|---|
| Speciality | Social Worker |
| Location | 4228 S Hocker Dr Bldg 12, Independence, Missouri |
| Authorized Official Name and Position | Laurie L Carpenter (OWNER/THERAPIST) |
| Authorized Official Contact | 8163817690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Life LLC 224 W Maple Ave Independence MO 64050-2816 Ph: (816) 381-7690 | Authentic Life LLC 4228 S Hocker Dr Bldg 12 Independence MO 64055-4754 Ph: (816) 381-7690 |
| NPI Number | 1437815255 |
|---|---|
| Provider Enumeration Date | 11/16/2021 |
| Last Update Date | 08/18/2026 |
| Certification Date | 08/18/2026 |
| Medicare PECOS PAC ID | 6002354743 |
|---|---|
| Medicare Enrollment ID | O20240813003386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437815255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Laurie L Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780227058 PECOS PAC ID: 5092253732 Enrollment ID: I20240813004036 |
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