Life Therapy Specialists of MD, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC2273 Issued in MD

Legal business name

LIFE THERAPY SPECIALISTS OF MD, LLC

Practice address

1927A York Rd
Lutherville, MD 21093-4225

Phone

(443) 417-4243

Fax

(315) 245-0352

NPI assigned

Mar 3, 2011

Last updated

Mar 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marie E Mastracco, LCPCNPI 1053538926

Title

President

Phone

(443) 417-4243

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marie E Mastracco, LCPC

  • Professional Counselor
  • Lutherville, MD
  • NPI 1053538926
  Authorized official Same address or phone

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1114225810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927A YORK RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934225",
            "telephone_number": "443-417-4243",
            "fax_number": "315-245-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927A YORK RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934225",
            "telephone_number": "443-417-4243",
            "fax_number": "315-245-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE THERAPY SPECIALISTS OF MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "MASTRACCO",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-417-4243",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC2273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.