Organization Active NPI

Life Management of Maryland

  • Clinical Social Worker
  • Salisbury, MD
National Provider Identifier
1275121113
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIFE MANAGEMENT OF MARYLAND
Practice address
209 E Market St Ste 10a
Salisbury, MD 21801-4992
Phone
(443) 503-3481
NPI assigned
Jan 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Authorized official

Name
Jerilisha Jones, LCSW-C
Title
Director
Phone
(443) 880-7859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

209 E Market St Ste 10a
Salisbury, MD 21801-4992

Mailing address

209 W Jewell St
Delmar, DE 19940-1008
Phone (443) 880-7859

Other practice location 1

212 W Main St Ste 306
Salisbury, MD 21801-5104
Phone (443) 503-3481

Other identifiers 1

IdentifierTypeStateIssuer
131585401MedicaidMD

National Provider Directory

National Provider Directory

Locations

212 W Main St
Ste 306
Salisbury, MD 21801
Phone (443) 503-3481

212 W Main St
Ste 308
Salisbury, MD 21801
Phone (302) 404-0373

209 E Market St
Ste 10A
Salisbury, MD 21801
Phone (443) 503-3481

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1275121113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W JEWELL ST",
            "city": "DELMAR",
            "state": "DE",
            "postal_code": "199401008",
            "telephone_number": "443-880-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E MARKET ST STE 10A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014992",
            "telephone_number": "443-503-3481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 W Main St Ste 306",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015104",
            "country_code": "US",
            "telephone_number": "443-503-3481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE MANAGEMENT OF MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JERILISHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-880-7859",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131585401",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.