Life Psychotherapy Center LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LIFE PSYCHOTHERAPY CENTER LLC

Practice address

10709 Birmingham Way
Woodstock, MD 21163-1403

Phone

(410) 995-8184

NPI assigned

May 24, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miya Williams

Title

Owner/Therapist

Phone

(410) 925-8392

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590278400000",
    "number": "1003439167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5479 GREEN DORY LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210441912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10709 BIRMINGHAM WAY",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211631403",
            "telephone_number": "410-995-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE PSYCHOTHERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-24",
        "last_updated": "2020-05-24",
        "certification_date": "2020-05-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIYA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "410-925-8392"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Woodstock, MD
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• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.