NPIMap

Organization Active NPI

Healthy Lives, LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1366827073
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
905711 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
Jul 23, 2015
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
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 connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 905711 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
Tax ID family
Healthy Lives LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1366827073",
    "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": "2015-07-23",
        "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_credential": "LCSW-C, LCADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "905711",
            "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.