# LIFE PHASES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275437329
- **Authorized official:** TANISHA PERINE-DIXON LPCC-S (CLINICAL COUNSELOR)
- **Authorized official phone:** (513) 405-7862

## Contact information

- **Practice address:** 4861 IMPERIAL DR, LIBERTY TWP, OH 45011-9089
- **Practice address phone:** (513) 405-7862
- **Mailing address:** 4861 IMPERIAL DR, LIBERTY TWP, OH 45011-9089
- **Mailing address phone:** (513) 405-7862

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |

## Other

- **Enumeration date:** 10/05/2026
- **Last updated:** 10/05/2026