NPIMap

Organization Active NPI

Lead 4 Life, Inc.

  • Community/Behavioral Health Agency
  • Rockville, MD
National Provider Identifier
1336532894
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LEAD 4 LIFE, INC.
Practice address
2096 Gaither Rd Ste 110
Rockville, MD 20850
Phone
(301) 672-4319
NPI assigned
Mar 9, 2015
Last updated
Aug 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Authorized official

Name
Ms. Jennifer Gauthier, LGSWNPI 1912142753
Title
Director
Phone
(301) 672-4319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2096 Gaither Rd Ste 110
Rockville, MD 20850

Mailing address

2096 Gaither Rd Ste 110
Rockville, MD 20850-4027
Phone (301) 672-4319

Other practice location 1

7979 Old Georgetown Rd
Floor 10
Bethesda, MD 20814-2429
Phone (301) 672-4319

Other practice location 2

7979 Old Georgetown Rd
Floor 10
Bethesda, MD 20814-2429
Phone (301) 672-4319

Other identifiers 1

IdentifierTypeStateIssuer
201507200MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Rockville

National Provider Directory

National Provider Directory
Tax ID family
Lead4Life Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

7979 Old Georgetown Rd
Fl 10
Bethesda, MD 20814

2096 Gaither Rd
Ste 110
Rockville, MD 20850

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1336532894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2096 GAITHER RD STE 110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504027",
            "telephone_number": "301-672-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2096 GAITHER RD STE 110",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20850",
            "telephone_number": "301-672-4319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7979 Old Georgetown Rd",
            "address_2": "Floor 10",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208142429",
            "country_code": "US",
            "telephone_number": "301-672-4319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7979 Old Georgetown Rd",
            "address_2": "Floor 10",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208142429",
            "country_code": "US",
            "telephone_number": "301-672-4319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEAD 4 LIFE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "GAUTHIER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-672-4319",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LGSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201507200",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Rockville",
            "affiliation": "N",
            "address_1": "2096 Gaither Rd Ste 110",
            "city": "Rockville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.