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Organization
LIFES ENERGY WELLNESS CENTER INC.
Active
Organization
LIFES ENERGY WELLNESS CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA KELLEY-FREEMAN, M.S., LCADC, LGPC, (CEO)
(800) 867-2395
Entity
Organization
Contact information
Practice address
514 POPLAR ST, CAMBRIDGE, MD 21613-1834
(800) 867-2395
Mailing address
PO BOX 123, EASTON, MD 21601-8901
(800) 867-2395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
NULL
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
NULL
163WH0200X
Home Health Registered Nurse
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
NULL
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
NULL
2084P0802X
Addiction Psychiatry Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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