Provider Demographics
NPI:1235963091
Name:LIFEQUEST COUNSELING SOLUTIONS LLC
Entity type:Organization
Organization Name:LIFEQUEST COUNSELING SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLYSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUPKO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSCW
Authorized Official - Phone:316-807-4418
Mailing Address - Street 1:PO BOX 21467
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-7467
Mailing Address - Country:US
Mailing Address - Phone:316-807-4188
Mailing Address - Fax:316-807-4188
Practice Address - Street 1:910 S BLUFFVIEW DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3024
Practice Address - Country:US
Practice Address - Phone:316-807-4418
Practice Address - Fax:888-316-9320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty