NPIMap

Organization Active NPI

Lifeworks Resources, LLC

  • Professional Counselor
  • Jackson, TN
National Provider Identifier
1811490964
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LIFEWORKS RESOURCES, LLC
Practice address
1186 Hwy 45 Bypass Ste D
Jackson, TN 38301-3256
Phone
(731) 215-0502
Fax
(731) 345-4086
NPI assigned
Mar 15, 2018
Last updated
Jul 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Mark Baldwin, LPC-MHSPNPI 1407069321
Title
President
Phone
(731) 467-0504

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)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

1186 Hwy 45 Bypass Ste D
Jackson, TN 38301-3256

Mailing address

1186 Hwy 45 Bypass Ste D
Jackson, TN 38301-3256
Phone (317) 215-0502

Other identifiers 1

IdentifierTypeStateIssuer
Q035248.MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240118001636 TN Part B Supplier - Clinic/Group Practice 2860844560 Receives reassigned benefits from 3 practitioners
Practice locations: Jackson, TN

National Provider Directory

National Provider Directory

Locations

1186 Highway 45 Byp
#D
Jackson, TN 38301
Phone (731) 215-0502

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1811490964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 HWY 45 BYPASS STE D",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013256",
            "telephone_number": "317-215-0502",
            "fax_number": "731-345-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1186 HWY 45 BYPASS STE D",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013256",
            "telephone_number": "731-215-0502",
            "fax_number": "731-345-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS RESOURCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-467-0504",
        "authorized_official_credential": "LPC-MHSP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q035248.",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.