NPIMap

Organization Active NPI

Lifes Energy Wellness Center Inc.

  • Community/Behavioral Health Agency
  • Cambridge, MD
National Provider Identifier
1497413413
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIFES ENERGY WELLNESS CENTER INC.
Practice address
514 Poplar St
Cambridge, MD 21613-1834
Phone
(800) 867-2395
Fax
(410) 443-0842
NPI assigned
Dec 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Authorized official

Name
Andrea Maria Kelley-Freeman
Title
Ceo
Phone
(800) 867-2395

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 225C00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

514 Poplar St
Cambridge, MD 21613-1834

Mailing address

514 Poplar St
Cambridge, MD 21613-1834
Phone (800) 867-2395

Other identifiers 1

IdentifierTypeStateIssuer
514MedicaidMD

Other names 2

  • Lifes Energy Wellness Center Inc. Doing business as
  • Lifes Energy Wellness Cneter Inc. Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1497413413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 POPLAR ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131834",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 POPLAR ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131834",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFES ENERGY WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-11-29",
        "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"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifes Energy Wellness Center Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifes Energy Wellness Cneter Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.