Organization
LIFE AND TRAUMA SURVIVOR CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRIE ANN SHIVOK LMHC (OWNER)
(219) 241-0212
Entity
Organization
Contact information
Practice address
402 WALL ST STE 42, VALPARAISO, IN 46383-2572
(219) 510-8043
(219) 241-8044
Mailing address
402 WALL ST STE 42, VALPARAISO, IN 46383-2572
(219) 510-8043
(219) 510-8044
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/08/2019
Last updated
11/04/2024
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