Provider Demographics
NPI:1447522800
Name:LIFE STRATEGIES LLC
Entity type:Organization
Organization Name:LIFE STRATEGIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:THORNTON
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-790-2700
Mailing Address - Street 1:2855 PRUITT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-3645
Mailing Address - Country:US
Mailing Address - Phone:803-790-2700
Mailing Address - Fax:
Practice Address - Street 1:2855 PRUITT DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-3645
Practice Address - Country:US
Practice Address - Phone:803-790-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC206862084P0804X
MDD00584322084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC206869Medicaid
SC1871579573OtherNPI
SCAA2269Medicare PIN