| Lifeworks Counseling & Consulting, Inc. | |
|
6202 Constitution Dr Ste D Fort Wayne IN 46804-1583 | |
| (260) 432-0066 | |
| (260) 432-8503 |
| Full Name | Lifeworks Counseling & Consulting, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 6202 Constitution Dr Ste D, Fort Wayne, Indiana |
| Authorized Official Name and Position | Amy Jo Aldrich (OWNER) |
| Authorized Official Contact | 2604320066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeworks Counseling & Consulting, Inc. 6202 Constitution Dr Ste D Fort Wayne IN 46804-1583 Ph: (260) 432-0066 | Lifeworks Counseling & Consulting, Inc. 6202 Constitution Dr Ste D Fort Wayne IN 46804-1583 Ph: (260) 432-0066 |
| NPI Number | 1184886541 |
|---|---|
| Provider Enumeration Date | 06/27/2008 |
| Last Update Date | 02/12/2024 |
| Certification Date | 02/12/2024 |
| Medicare PECOS PAC ID | 6204986573 |
|---|---|
| Medicare Enrollment ID | O20090608000291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184886541 | NPI | - | NPPES |
| 200912670A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 39001451 (Indiana) | Primary |
| Provider Name | Mackenzie Taylor Rice |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871019844 PECOS PAC ID: 2668815861 Enrollment ID: I20240205002387 |
| Provider Name | Sharon S Miley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1164608022 PECOS PAC ID: 5698214120 Enrollment ID: I20240828004439 |
| Provider Name | Amy J Aldrich |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598981649 PECOS PAC ID: 9830249101 Enrollment ID: I20241119004344 |
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