NPIMap

Organization Active NPI

Successful Life Coaching and Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Upper Marlboro, MD
National Provider Identifier
1871442673
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SUCCESSFUL LIFE COACHING AND COUNSELING SERVICES, LLC
Practice address
11510 Pegasus CT
Upper Marlboro, MD 20772-7823
Phone
(240) 221-1617
NPI assigned
Jan 26, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Authorized official

Name
Staci C Burrough, MA, LCPC, LAPCNPI 1538801782
Title
Owner
Phone
(240) 221-1617

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

11510 Pegasus CT
Upper Marlboro, MD 20772-7823

Mailing address

11510 Pegasus CT
Upper Marlboro, MD 20772-7823
Phone (240) 221-1617

National Provider Directory

National Provider Directory

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": "1769385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1871442673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11510 PEGASUS CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207727823",
            "telephone_number": "240-221-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11510 PEGASUS CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207727823",
            "telephone_number": "240-221-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESSFUL LIFE COACHING AND COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-25",
        "status": "A",
        "authorized_official_last_name": "BURROUGH",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-221-1617",
        "authorized_official_credential": "MA, LCPC, LAPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; 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.