| Lifes Path Llc | |
|
101 N Woodland Blvd Ste A306 Deland FL 32720-4240 | |
| (321) 578-8479 | |
| Not Available |
| Full Name | Lifes Path Llc |
|---|---|
| Speciality | Counselor |
| Location | 101 N Woodland Blvd Ste A306, Deland, Florida |
| Authorized Official Name and Position | Kiara Nieves (OWNER) |
| Authorized Official Contact | 3863271519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifes Path Llc 101 N Woodland Blvd Ste A306 Deland FL 32720-4240 Ph: (386) 327-1519 | Lifes Path Llc 101 N Woodland Blvd Ste A306 Deland FL 32720-4240 Ph: (321) 578-8479 |
| NPI Number | 1013753235 |
|---|---|
| Provider Enumeration Date | 07/08/2024 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Medicare PECOS PAC ID | 6608313481 |
|---|---|
| Medicare Enrollment ID | O20240730002811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013753235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kiara Ivette Nieves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811535321 PECOS PAC ID: 8628421294 Enrollment ID: I20240130003634 |
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