# LIFE OF ABUNDANCE BEHAVIORAL HEALTH SERVICES LLC

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

## Provider details

- **NPI number:** 1235773193
- **Authorized official:** JACQUELINE EJIM LCPC (CEO/DIRECTOR)
- **Authorized official phone:** (443) 721-7574

## Contact information

- **Practice address:** 7544 HOLABIRD AVE, DUNDALK, MD 21222-2104
- **Practice address phone:** (443) 721-7574
- **Mailing address:** 1281 SUGARWOOD CIR, ESSEX, MD 21221-5447
- **Mailing address phone:** (443) 721-7574

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 225C00000X | Rehabilitation Counselor | — | NULL | — |
| 225C00000X | Rehabilitation Counselor | — | — | — |

## Other

- **Enumeration date:** 11/04/2019
- **Last updated:** 05/27/2021