Organization
CREATE YOUR LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON DARLENE HOWARD LCPC, LPC (LIC.CLIN. PROF. COUNSELOR)
(202) 422-7337
Entity
Organization
Contact information
Practice address
10665 STANHAVEN PL STE 3119, WHITE PLAINS, MD 20695-3055
(240) 448-3711
Mailing address
10665 STANHAVEN PL STE 3119, WHITE PLAINS, MD 20695-3055
(240) 448-3711
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC1508
MD
101YP2500X
Professional Counselor
PRC13741
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001437100
—
MD
01
—
2132324
MAMSI
MD
01
—
358105
MHN
MD
01
—
60980001
BLUE CROSS BLUE SHIELD
DC
01
—
645523-03
BLUE CROSS BLUE SHIELD
MD
01
—
743688000
MAGELLEAN
MD
Enumeration date
06/13/2016
Last updated
11/02/2024
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