Provider Demographics
NPI:1174019087
Name:LIFE CONNECTIONS COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:LIFE CONNECTIONS COUNSELING SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFALCO GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP, NCC
Authorized Official - Phone:865-888-5818
Mailing Address - Street 1:408 N CEDAR BLUFF RD STE 305
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-3648
Mailing Address - Country:US
Mailing Address - Phone:865-888-5818
Mailing Address - Fax:865-888-5819
Practice Address - Street 1:408 N CEDAR BLUFF RD STE 305
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3648
Practice Address - Country:US
Practice Address - Phone:865-888-5818
Practice Address - Fax:865-888-5819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1851430318OtherNPI