Provider Demographics
NPI:1447688338
Name:LIFE & WORK SOULUTIONS, INC.
Entity type:Organization
Organization Name:LIFE & WORK SOULUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIPP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:407-415-2493
Mailing Address - Street 1:3400 HUNTERS CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7230
Mailing Address - Country:US
Mailing Address - Phone:407-415-2493
Mailing Address - Fax:888-216-6045
Practice Address - Street 1:3400 HUNTERS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7230
Practice Address - Country:US
Practice Address - Phone:407-415-2493
Practice Address - Fax:888-216-6045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5173251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003467601Medicaid