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Organization
LIFE FULLY LIVED, LLC
Active
Organization
LIFE FULLY LIVED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN DOYLE LPCMH (OWNER)
(443) 466-7038
Entity
Organization
Contact information
Practice address
19 BRANDYWINE BLVD, TALLEYVILLE, DE 19803-1838
(302) 703-7779
Mailing address
19 BRANDYWINE BLVD, TALLEYVILLE, DE 19803-1838
(302) 703-7779
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/08/2021
Last updated
12/24/2023
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