NPIMap

Organization Active NPI

New Life Behavioral Health Program LLC

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
National Provider Identifier
1477071637
Registry record updated Sep 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
NEW LIFE BEHAVIORAL HEALTH PROGRAM LLC
Practice address
1818 Walbrook Ave
Baltimore, MD 21217-1311
Phone
(443) 270-4357
NPI assigned
Sep 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2017

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

Authorized official

Name
Joann L Staten, PHD
Title
Owner
Phone
(443) 270-4357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

1818 Walbrook Ave
Baltimore, MD 21217-1311

Mailing address

3627 Keystone Ave Apt 4
Los Angeles, CA 90034-5616
Phone (323) 309-1645

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504742400000",
    "number": "1477071637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 KEYSTONE AVE APT 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345616",
            "telephone_number": "323-309-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 WALBROOK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212171311",
            "telephone_number": "443-270-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE BEHAVIORAL HEALTH PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-09-07",
        "status": "A",
        "authorized_official_last_name": "STATEN",
        "authorized_official_first_name": "JOANN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-270-4357",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "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 Sep 7, 2017; 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.