Restorative Life Therapy Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESTORATIVE LIFE THERAPY SERVICES, LLC

Practice address

2908 Mueserbush CT
Glenarden, MD 20706-5514

Phone

(443) 743-2563

NPI assigned

Oct 18, 2021

Last updated

Oct 28, 2021By 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

Kanisha R Barnes, LICSW, LCSW-CNPI 1922407345

Title

Clinical Social Worker

Phone

(443) 743-2563

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

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.

• Kanisha R Barnes, LCSW-C, LICSW

  • Addiction (Substance Use Disorder) Counselor
  • Glenarden, MD
  • NPI 1922407345

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1760145734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10530 CAMPUS WAY S # 1118",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207741309",
            "telephone_number": "443-743-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 MUESERBUSH CT",
            "city": "GLENARDEN",
            "state": "MD",
            "postal_code": "207065514",
            "telephone_number": "443-743-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE LIFE THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "KANISHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "443-743-2563",
        "authorized_official_credential": "LICSW, LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "734503800",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbarnes@restorativelifetherapy.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "10530 Campus Way S # 1118",
            "city": "Largo",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207741309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edith Kema Paul
• Jacqeline Vanesa Perdomo
• Faye Ann Proctor
• Peggy Randall, HHA
• Darius Douglas Reed
• Abby Russell
• Ebony Oasis Sanders
• Danteh Sema
• Zoe Toma Sherman
• Nimi Sikri, OD

• Clinical Social Worker in Glenarden, MD
• Providers in Glenarden, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.