Active NPI
Life Support Clinical Counseling Service LLC
- Mental Health Counselor
- Severn, MD
National Provider Identifier
1528538105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- LIFE SUPPORT CLINICAL COUNSELING SERVICE LLC
- Practice address
- 82 Janet Dale LN
Severn, MD 21144 - Phone
- (410) 980-3163
- Fax
- (410) 969-2958
- NPI assigned
- Nov 27, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Alice Rita Hunley, LCPC
- Title
- Ceo
- Phone
- (410) 980-3163
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
82 Janet Dale LN
Severn, MD 21144
Mailing address
82 Janet Dale LN
Severn, MD 21144
Phone (410) 980-3163
National Provider Directory
National Provider Directory- Tax ID family
- Life Support Clinical Counseling Service LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Glen Burnie, MD
- NPI 1477186278
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": "1543276800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1543276800000",
"number": "1528538105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 JANET DALE LN",
"city": "SEVERN",
"state": "MD",
"postal_code": "21144",
"telephone_number": "410-980-3163",
"fax_number": "410-969-2958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 JANET DALE LN",
"city": "SEVERN",
"state": "MD",
"postal_code": "21144",
"telephone_number": "410-980-3163",
"fax_number": "410-969-2958"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE SUPPORT CLINICAL COUNSELING SERVICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-27",
"last_updated": "2018-11-27",
"status": "A",
"authorized_official_last_name": "HUNLEY",
"authorized_official_first_name": "ALICE",
"authorized_official_middle_name": "RITA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "410-980-3163",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCPC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severn, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.