| Life Crafters, Llc | |
|
535 W Second St Ste L110 Lexington KY 40508-9002 | |
| (859) 630-7760 | |
| Not Available |
| Full Name | Life Crafters, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 535 W Second St Ste L110, Lexington, Kentucky |
| Authorized Official Name and Position | Madison Leigh Wallace (CEO) |
| Authorized Official Contact | 8596307760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Crafters, Llc 369 W Vine St Apt 1906 Lexington KY 40507-1697 Ph: (859) 630-7760 | Life Crafters, Llc 535 W Second St Ste L110 Lexington KY 40508-9002 Ph: (859) 630-7760 |
| NPI Number | 1871196675 |
|---|---|
| Provider Enumeration Date | 11/16/2020 |
| Last Update Date | 11/17/2020 |
| Certification Date | 11/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871196675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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