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Organization

LIFESTYLE INNOVATIONS COUNSELING AND CONSULTING INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ANDREANA YANCEY LCSW-C (CEO/THERAPIST)
(202) 627-9892
Entity
Organization

Contact information

Practice address
15912 CRAIN HWY STE B125, BRANDYWINE, MD 20613-8035
(202) 627-9892
Mailing address
15912 CRAIN HWY STE B125, BRANDYWINE, MD 20613-8035
(202) 627-9892

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MD
261QM0850X
Adult Mental Health Clinic/Center
MD
261QM0855X
Adolescent and Children Mental Health Clinic/Center
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
221208100
MD
Enumeration date
06/21/2018
Last updated
06/21/2018
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