# LIFESPAN COUNSELING AT THE KIDS COUCH INC LLC

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

## Provider details

- **NPI number:** 1710423041
- **Authorized official:** OLGA YATZUS LPCMH (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (302) 384-8222

## Contact information

- **Practice address:** 5700 KIRKWOOD HWY, SUITE 203, WILMINGTON, DE 19808-4857
- **Practice address phone:** (302) 384-8222
- **Practice address fax:** (302) 407-6698
- **Mailing address:** 5700 KIRKWOOD HWY, SUITE 203, WILMINGTON, DE 19808-4857
- **Mailing address phone:** (302) 384-8222
- **Mailing address fax:** (302) 407-6698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | PC-0000362 | DE | Yes |

## Other

- **Enumeration date:** 01/10/2017
- **Last updated:** 01/10/2017