OrganizationActive
Life Interrupted Counseling Services
NPI 1609433291 · Mental Health Counselor · Charlotte, NC
Provider details
- NPI number
- 1609433291
- Entity type
- Organization
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Keshia Keith, Owner(980) 404-1069
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4045 N Tryon St Ste a
Charlotte, NC 28206
Phone: (980) 404-1069
Fax: (877) 766-6203
Street-level locationGet directions
Mailing address
516 Highland Ridge PT
Clover, SC 29710-5507
Additional practice locations (1)
- 516 Highland Ridge PTClover, SC 29710-5507Phone: (980) 404-1069Fax: (877) 766-6203
Registry dates
- Enumerated
- 2019-05-20
- Last updated
- 2019-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.