| Redesign Your Life Counseling Llc | |
|
130 N Gross Rd Ste 205 Kingsland GA 31548-6277 | |
| (912) 467-9538 | |
| Not Available |
| Full Name | Redesign Your Life Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 130 N Gross Rd Ste 205, Kingsland, Georgia |
| Authorized Official Name and Position | Alessandra M Ellis-lodmell (THERAPIST) |
| Authorized Official Contact | 9124679538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Redesign Your Life Counseling Llc 121tidal Marsh Way Saint Marys GA 31558-5809 Ph: (912) 467-9538 | Redesign Your Life Counseling Llc 130 N Gross Rd Ste 205 Kingsland GA 31548-6277 Ph: (912) 467-9538 |
| NPI Number | 1124842034 |
|---|---|
| Provider Enumeration Date | 11/08/2024 |
| Last Update Date | 01/15/2025 |
| Certification Date | 01/15/2025 |
| Medicare PECOS PAC ID | 8426582230 |
|---|---|
| Medicare Enrollment ID | O20241114004329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124842034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alessandra M Ellis-lodmell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932949443 PECOS PAC ID: 4789118597 Enrollment ID: I20241114004437 |
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