# LIFETIME COUNSELING SERVICE & MANAGEMENT SERVICES

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

## Provider details

- **NPI number:** 1669870697
- **Authorized official:** MRS. LAFRANCINE WELLS BRADFORD LICENSE MFT (OWNER)
- **Authorized official phone:** (229) 630-2691

## Contact information

- **Practice address:** 2905 BEMISS RD, VALDOSTA, GA 31602-7007
- **Practice address phone:** (229) 630-2691
- **Practice address fax:** (888) 974-8762
- **Mailing address:** PO BOX 2961, VALDOSTA, GA 31604-2961
- **Mailing address phone:** (229) 630-2691
- **Mailing address fax:** (888) 974-8762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MFT001200 | GA | Yes |

## Other

- **Enumeration date:** 12/08/2014
- **Last updated:** 12/08/2014