Organization
LIFE BUILDERS H.R. & P.I. CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAVONDA JACKSON (EXECUTIVE DIRECTOR)
(219) 670-0311
Entity
Organization
Contact information
Practice address
6111 HARRISON ST STE 206, MERRILLVILLE, IN 46410-2973
(219) 670-0311
Mailing address
6111 HARRISON ST STE 206, MERRILLVILLE, IN 46410-2973
(219) 670-0311
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
39001377A
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
39001377A
IN
101YM0800X
Mental Health Counselor
Primary
39001377A
IN
101YP2500X
Professional Counselor
39001377A
IN
106H00000X
Marriage & Family Therapist
39001377A
IN
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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