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Organization
LIFEMARK INC.
Active
Organization
LIFEMARK INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARION TRAVERS LCPC (CEO/CLINICAL DIRECTOR)
(443) 859-8584
Entity
Organization
Contact information
Practice address
1342 S DIVISION ST STE 401, SALISBURY, MD 21804-6921
(443) 859-8584
(443) 859-8496
Mailing address
1342 S DIVISION ST STE 401, SALISBURY, MD 21804-6921
(443) 859-8584
(443) 859-8496
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053972400
—
MD
05
—
068375200
—
MD
Enumeration date
05/15/2013
Last updated
03/15/2023
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