Organization
NEW LIFE WELLNESS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONETTA MASON LCPC (CEO/COO)
(443) 285-9846
Entity
Organization
Contact information
Practice address
110 W MULBERRY ST STE 100, BALTIMORE, MD 21201-3606
(443) 203-8555
Mailing address
23 RED HEARTH CT, HALETHORPE, MD 21227-3833
(443) 285-9846
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
835005100
—
MD
Enumeration date
02/27/2020
Last updated
03/15/2021
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