# LIFES ENERGY WELLNESS CENTER INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053800110
- **Authorized official:** ANDREA KELLEY-FREEMAN, M.S., LCADC, LGPC, (CEO)
- **Authorized official phone:** (800) 867-2395

## Contact information

- **Practice address:** 514 POPLAR ST, CAMBRIDGE, MD 21613-1834
- **Practice address phone:** (800) 867-2395
- **Mailing address:** PO BOX 123, EASTON, MD 21601-8901
- **Mailing address phone:** (800) 867-2395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 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