Organization
LIFES ENERGY WELLNESS CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA MARIA KELLEY-FREEMAN LCADC, LGPC (CEO)
(800) 867-2395
Entity
Organization
Contact information
Practice address
8737 BROOKS DR, EASTON, MD 21601
(443) 496-0245
Mailing address
8737 BROOKS DR STE 108, EASTON, MD 21601-7474
(800) 867-2395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
BH000195
MD
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
BH000195
MD
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
BH00095
MD
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
08/24/2017
Last updated
05/25/2018
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