Basic Information
| Provider Information | |||||||||
| NPI: | 1083994883 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LIFE WORKS KINSTON, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 704C PLAZA BLVD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285011657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522081710 | ||||||||
| FaxNumber: | 2522080746 | ||||||||
| Practice Location | |||||||||
| Address1: | 704C PLAZA BLVD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285011657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522081710 | ||||||||
| FaxNumber: | 2522080746 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2011 | ||||||||
| LastUpdateDate: | 08/24/2011 | ||||||||
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| AuthorizedOfficialLastName: | SPERATI | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | FREELAND | ||||||||
| AuthorizedOfficialTitleorPosition: | THERAPIST/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9193890211 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | C005984 | NC | Y | Agencies | Community/Behavioral Health |
No ID Information.