| Lift Counseling Services Llc | |
|
8670b Broadway Merrillville IN 46410-7034 | |
| (219) 716-2138 | |
| Not Available |
| Full Name | Lift Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 8670b Broadway, Merrillville, Indiana |
| Authorized Official Name and Position | Jonnarda Tolbert (OWNER) |
| Authorized Official Contact | 2197818791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lift Counseling Services Llc 6555 Monda Ave Portage IN 46368-4692 Ph: (219) 781-8791 | Lift Counseling Services Llc 8670b Broadway Merrillville IN 46410-7034 Ph: (219) 716-2138 |
| NPI Number | 1780350496 |
|---|---|
| Provider Enumeration Date | 08/22/2021 |
| Last Update Date | 06/10/2024 |
| Certification Date | 06/03/2024 |
| Medicare PECOS PAC ID | 6608318217 |
|---|---|
| Medicare Enrollment ID | O20240611002915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780350496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jonnarda Tolbert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407359805 PECOS PAC ID: 9537602529 Enrollment ID: I20240619000067 |
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