Provider Demographics
NPI:1679307607
Name:RESTORE LIFE COUNSELING
Entity type:Organization
Organization Name:RESTORE LIFE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DONNELL
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, EMDR
Authorized Official - Phone:346-740-8300
Mailing Address - Street 1:25511 BUDDE RD STE 3504
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-4065
Mailing Address - Country:US
Mailing Address - Phone:713-582-5108
Mailing Address - Fax:
Practice Address - Street 1:25511 BUDDE RD STE 3504
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-4065
Practice Address - Country:US
Practice Address - Phone:346-740-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty