Organization
LIFECRAFTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADISON WALLACE LPCC (MANAGING PARTNER)
(859) 630-7760
Entity
Organization
Contact information
Practice address
600 HIGH ST, HAZARD, KY 41701-1310
(859) 630-7760
Mailing address
369 W VINE ST APT 1906, LEXINGTON, KY 40507-1697
(859) 630-7760
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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