NPIMap

Organization Active NPI

Healthy Lives, LLC

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1114268661
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16481 Issued in MD
Legal business name
HEALTHY LIVES, LLC
Practice address
1001 Pine Heights Ave Ste 303
Baltimore, MD 21229-5202
Phone
(443) 219-7901
Fax
(443) 835-2521
NPI assigned
Mar 8, 2013
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Mr. Ahmein Watson, LCSW-C, LCADCNPI 1588938237
Title
Ceo
Phone
(443) 722-3116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16481 MD Primary

Addresses

Primary practice location

1001 Pine Heights Ave Ste 303
Baltimore, MD 21229-5202

Mailing address

1001 Pine Heights Ave Ste 303
Baltimore, MD 21229-5202
Phone (443) 219-7901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151208000085 MD Part B Supplier - Clinic/Group Practice 5193025534 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Halethorpe, MD

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1114268661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PINE HEIGHTS AVE STE 303",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295202",
            "telephone_number": "443-219-7901",
            "fax_number": "443-835-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PINE HEIGHTS AVE STE 303",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295202",
            "telephone_number": "443-219-7901",
            "fax_number": "443-835-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "AHMEIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-722-3116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-C, LCADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.