Living Free Health Services

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

149 Issued in VA

Legal business name

LIVING FREE HEALTH SERVICES

Practice address

4306 Evergreen LN Ste 204
Annandale, VA 22003-3217

Phone

(703) 750-1292

Fax

(703) 642-0859

NPI assigned

Mar 24, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Marietta Warden, R.N., C.C.S.,C.A.C

Title

President

Phone

(703) 750-1292

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1376660233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 EVERGREEN LN STE 204",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033217",
            "telephone_number": "703-750-1292",
            "fax_number": "703-642-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 EVERGREEN LN STE 204",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033217",
            "telephone_number": "703-750-1292",
            "fax_number": "703-642-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING FREE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-24",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "WARDEN",
        "authorized_official_first_name": "MARIETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-750-1292",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N., C.C.S.,C.A.C"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "149",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "GV6",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST  CAREFIRST BLUE",
            "identifier": "GV6",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Annandale, VA
• Providers in Annandale, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; 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.