Organization
LIFESPAN COUNSELING SERVICES LLC
Active
Other names
Lifespan Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA LOUISE CASCIATO (OFFICE MANAGER)
(727) 214-8267
Entity
Organization
Contact information
Practice address
14952 NEWPORT RD, CLEARWATER, FL 33764-7085
(727) 214-8267
Mailing address
14952 NEWPORT RD, CLEARWATER, FL 33764-7085
(172) 721-4826
(727) 475-8965
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C230172637890
DRIVER'S LICENSE
FL
Enumeration date
03/06/2022
Last updated
03/06/2022
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