Organization
LIFES ENERGY WELLNESS CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA M KELLEY-FREEMAN LCADC (CEO)
(800) 867-2395
Entity
Organization
Contact information
Practice address
514 POPLAR ST, CAMBRIDGE, MD 21613-1834
(180) 867-2395
Mailing address
8737 BROOKS DR STE 108, EASTON, MD 21601-7474
(443) 496-0245
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BH000384
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA2304
—
101YP2500X
Professional Counselor
LCA2304
—
101YP2500X
Professional Counselor
Primary
—
—
101YS0200X
School Counselor
LCA2304
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/03/2017
Last updated
05/04/2018
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