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LIFE INTERRUPTED COUNSELING SERVICES
NPI 1609433291
Counselor - Mental Health in Charlotte, NC

Active since May 20, 2019
4045 N TRYON ST STE A, CHARLOTTE, NC 28206(980) 404-1069(877) 766-6203 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 11, 2019, May 20, 2019 (2 updates tracked since 2019).

About Life Interrupted Counseling Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE INTERRUPTED COUNSELING SERVICES (NPI 1609433291) is a healthcare organization registered as a mental health in Charlotte, North Carolina and active in the NPI registry since May 2019. The organization maintains a secondary practice location in Clover and lists Keshia Donuel Keith, Owner, as its authorized official.

NPPES Registry Identity

NPI1609433291
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameLIFE INTERRUPTED COUNSELING SERVICES
Location Address4045 N TRYON ST STE ACharlotte, NC 28206
Mailing Address516 Highland Ridge PtClover, SC 29710-5507 · (980) 322-3466 · Fax (877) 766-6203
Phone(980) 404-1069
Fax(877) 766-6203
Organization SubpartNo
Authorized OfficialKeshia Donuel KeithOwner · (980) 404-1069
Enumeration DateMay 20, 2019
Last NPPES UpdateJune 11, 20192 updates tracked since enumeration
✔ NPI 1609433291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
4045 N TRYON ST STE A, Charlotte, NC 28206
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Secondary Practice Location 1

Location 1516 Highland Ridge PtClover, SC 29710-5507 · Phone (980) 404-1069 · Fax (877) 766-6203

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Interrupted Counseling Services's NPI number?

The NPI number for Life Interrupted Counseling Services is 1609433291. It was assigned to this organization in the NPPES registry on May 20, 2019.

Where is Life Interrupted Counseling Services located?

Life Interrupted Counseling Services is located at 4045 N Tryon St Ste A, Charlotte, NC 28206. The listed phone number is (980) 404-1069.

What is Life Interrupted Counseling Services's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Life Interrupted Counseling Services was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.