| Edit Your Life Inc | |
|
715 E Golf Rd Ste 200a1a Schaumburg IL 60173-4597 | |
| (847) 514-0432 | |
| Not Available |
| Full Name | Edit Your Life Inc |
|---|---|
| Speciality | Counselor |
| Location | 715 E Golf Rd Ste 200a1a, Schaumburg, Illinois |
| Authorized Official Name and Position | Lara Garwood-martin (OWNER) |
| Authorized Official Contact | 8475140432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edit Your Life Inc 715 E Golf Rd Ste 200a1a Schaumburg IL 60173-4597 Ph: (847) 514-0432 | Edit Your Life Inc 715 E Golf Rd Ste 200a1a Schaumburg IL 60173-4597 Ph: (847) 514-0432 |
| NPI Number | 1306512389 |
|---|---|
| Provider Enumeration Date | 08/19/2021 |
| Last Update Date | 09/08/2022 |
| Certification Date | 09/08/2022 |
| Medicare PECOS PAC ID | 5597108191 |
|---|---|
| Medicare Enrollment ID | O20240212000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306512389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Lara Garwood-martin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720550999 PECOS PAC ID: 0941643548 Enrollment ID: I20240212000846 |
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