Organization
LIFELINE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD LONG (ADMINISTRATOR)
(903) 578-3589
Entity
Organization
Contact information
Practice address
751 SPENCER LN, TYLER, TX 75704-6671
(903) 578-3589
Mailing address
751 SPENCER LN, TYLER, TX 75704-6671
(903) 578-3589
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/18/2025
Last updated
10/18/2025
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