Create Your Life, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC1508 Issued in MD

Legal business name

CREATE YOUR LIFE, LLC

Practice address

10665 Stanhaven PL Ste 3119
White Plains, MD 20695-3055

Phone

(240) 448-3711

NPI assigned

Jun 13, 2016

Last updated

Nov 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shannon Darlene Howard, LCPC, LPCNPI 1164562278

Title

Lic.Clin. Prof. Counselor

Phone

(202) 422-7337

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon Howard

  • Professional Counselor
  • White Plains, MD
  • NPI 1164562278
  NPD Authorized official
• Andrea Michelle Williams, PSYD

  • Clinical Psychologist
  • White Plains, MD
  • NPI 1114466869
  Medicare reassignment

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730505600000",
    "number": "1639529407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PL STE 3119",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953055",
            "telephone_number": "240-448-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PL STE 3119",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953055",
            "telephone_number": "240-448-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATE YOUR LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-11-02",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "LIC.CLIN. PROF. COUNSELOR",
        "authorized_official_telephone_number": "202-422-7337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCPC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC1508",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC13741",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "645523-03",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60980001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLEAN",
            "identifier": "743688000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "358105",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001437100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2132324",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aryian Lurecia Cooke, M.D.
• Core Value Corporation (Southern Maryland Dietitian)
• Alayna Camryn Cox, PTA
• Lorie F Cram, MD
• Cranial Crowns
• Marcus Crosby
• Leslie Cross, LCPC
• Cultivating Hope Counseling LLC
• Felicia Dalton
• Nicole Daniels, LCMFT

• Professional Counselor in White Plains, MD
• Providers in White Plains, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; 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.