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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 MS, LCADC, LCPC (CEO)
(800) 867-2395
Entity
Organization
Contact information
Practice address
2324 WEST ZION ROAD SUITE 112, SUITE 112, SALISBURY, MD 21804
(800) 867-2395
Mailing address
PO BOX 123, EASTON, MD 21601-8901
(800) 867-2395
(410) 443-0842
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
103TF0000X
Family Psychologist
—
NULL
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
NULL
103TF0200X
Forensic Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
NULL
103TR0400X
Rehabilitation Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
NULL
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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