| Life-spire Counseling Services Llc | |
|
505 Deltona Blvd Ste 201 Deltona FL 32725-8069 | |
| (386) 400-3100 | |
| Not Available |
| Full Name | Life-spire Counseling Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 505 Deltona Blvd Ste 201, Deltona, Florida |
| Authorized Official Name and Position | Janae Ponder (OWNER) |
| Authorized Official Contact | 3864003100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life-spire Counseling Services Llc 780 Deltona Blvd Ste 102 Deltona FL 32725-7128 Ph: (386) 400-3100 | Life-spire Counseling Services Llc 505 Deltona Blvd Ste 201 Deltona FL 32725-8069 Ph: (386) 400-3100 |
| NPI Number | 1609350651 |
|---|---|
| Provider Enumeration Date | 09/16/2018 |
| Last Update Date | 02/02/2023 |
| Certification Date | 01/07/2021 |
| Medicare PECOS PAC ID | 6406269364 |
|---|---|
| Medicare Enrollment ID | O20210113003075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609350651 | NPI | - | NPPES |
| Provider Name | Janae Therese Ponder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194127282 PECOS PAC ID: 0941613806 Enrollment ID: I20210113003094 |
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