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Organization

AUTHENTIC LIFE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LAURIE L CARPENTER LCSW, LSCSW (OWNER/THERAPIST)
(816) 381-7690
Entity
Organization

Contact information

Practice address
224 W MAPLE AVE, INDEPENDENCE, MO 64050-2816
(816) 381-7690
(816) 381-7652
Mailing address
224 W MAPLE AVE, INDEPENDENCE, MO 64050-2816
(816) 381-7690
(816) 381-7652

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
11/16/2021
Last updated
08/17/2022
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