Provider Demographics
NPI:1578447900
Name:LIVE WELL OF LAKE COUNTY
Entity type:Organization
Organization Name:LIVE WELL OF LAKE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HESS-METZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-339-1810
Mailing Address - Street 1:1392 WENTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:VOLO
Mailing Address - State:IL
Mailing Address - Zip Code:60020-3416
Mailing Address - Country:US
Mailing Address - Phone:757-339-1810
Mailing Address - Fax:
Practice Address - Street 1:1590 S MILWAUKEE AVE STE 303
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3786
Practice Address - Country:US
Practice Address - Phone:224-358-3808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health