Provider Demographics
NPI:1679889174
Name:LIFEWORK, LLC
Entity type:Organization
Organization Name:LIFEWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENNEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-910-8608
Mailing Address - Street 1:2055 CRAIGSHIRE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4012
Mailing Address - Country:US
Mailing Address - Phone:314-910-8608
Mailing Address - Fax:314-392-9601
Practice Address - Street 1:1000 EXECUTIVE PARKWAY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6325
Practice Address - Country:US
Practice Address - Phone:314-910-8608
Practice Address - Fax:314-392-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020013811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty