Organization Active NPI

Lifes Energy Wellness Center Inc.

  • Professional Counselor
  • Easton, MD
National Provider Identifier
1316464951
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
BH000195 Issued in MD
Legal business name
LIFES ENERGY WELLNESS CENTER INC.
Practice address
8737 Brooks Dr
Easton, MD 21601
Phone
(443) 496-0245
NPI assigned
Aug 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Authorized official

Name
Mrs. Andrea Maria Kelley-Freeman, LCADC, LGPC
Title
Ceo
Phone
(800) 867-2395

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X BH000195 MD Primary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Adolescent and Children Mental Health Clinic/Center 261QM0855X BH000195 MD
Multi-Specialty Clinic/Center 261QM1300X BH00095 MD
Substance Abuse Rehabilitation Facility 324500000X
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

8737 Brooks Dr
Easton, MD 21601

Mailing address

8737 Brooks Dr Ste 108
Easton, MD 21601-7474
Phone (800) 867-2395

National Provider Directory

National Provider Directory
Tax ID family
Lifes Energy Wellness Center Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8737 Brooks Dr
Easton, MD 21601
Phone (410) 822-6223

8737 Brooks Dr
Ste 108
Easton, MD 21601
Phone (410) 770-3060

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527206400000",
    "number": "1316464951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8737 BROOKS DR STE 108",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017474",
            "telephone_number": "800-867-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8737 BROOKS DR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "21601",
            "telephone_number": "443-496-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFES ENERGY WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2018-05-25",
        "status": "A",
        "authorized_official_last_name": "KELLEY-FREEMAN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-867-2395",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCADC, LGPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "BH000195",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MD",
            "license": "BH000195",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MD",
            "license": "BH00095",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.