| Cycle Of Life Counseling, Pllc | |
|
15720 Brixham Hill Ave Ste 300 Charlotte NC 28277-4784 | |
| (704) 412-8360 | |
| (704) 603-3006 |
| Full Name | Cycle Of Life Counseling, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 15720 Brixham Hill Ave Ste 300, Charlotte, North Carolina |
| Authorized Official Name and Position | Lisa M Devore (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 7044128360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cycle Of Life Counseling, Pllc 15720 Brixham Hill Ave Ste 300 Charlotte NC 28277-4784 Ph: (704) 412-8360 | Cycle Of Life Counseling, Pllc 15720 Brixham Hill Ave Ste 300 Charlotte NC 28277-4784 Ph: (704) 412-8360 |
| NPI Number | 1164882759 |
|---|---|
| Provider Enumeration Date | 02/25/2016 |
| Last Update Date | 11/13/2020 |
| Certification Date | 11/13/2020 |
| Medicare PECOS PAC ID | 4688972615 |
|---|---|
| Medicare Enrollment ID | O20160407001437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164882759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Lisa M Devore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588976971 PECOS PAC ID: 5597063529 Enrollment ID: I20160407001487 |
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