NPIMap

Organization Active NPI

Lifes Energy Wellness Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Easton, MD
National Provider Identifier
1902462427
Registry record updated May 15, 2019
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
LIFES ENERGY WELLNESS CENTER INC.
Doing business as
Life's Energy Wellness Center Inc.
Practice address
8737 Brooks Dr Ste 108
Easton, MD 21601-7474
Phone
(800) 867-2395
Fax
(410) 443-0842
NPI assigned
May 10, 2019
Last updated
May 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Authorized official

Name
Andrea Kelley-Freeman, LCPC, LCADCNPI 1477974277
Title
Ceo
Phone
(800) 867-2395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Counseling Psychologist 103TC1900X NU
Psychoanalysis Psychologist 103TP0814X NU
Social Worker 104100000X NU
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X NU
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X NU
Psychiatry Physician 2084P0800X NU
Addiction Psychiatry Physician 2084P0802X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X NU

Addresses

Primary practice location

8737 Brooks Dr Ste 108
Easton, MD 21601-7474

Mailing address

PO Box 123
Easton, MD 21601-8901
Phone (800) 867-2395

Other names 1

  • Life's Energy Wellness Center Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifes Energy Wellness Center Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8737 Brooks Dr
Ste 108
Easton, MD 21601
Phone (410) 770-3060

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1902462427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216018901",
            "telephone_number": "800-867-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8737 BROOKS DR STE 108",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017474",
            "telephone_number": "800-867-2395",
            "fax_number": "410-443-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFES ENERGY WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "KELLEY-FREEMAN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-867-2395",
        "authorized_official_credential": "LCPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life's Energy Wellness Center Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life's Energy Wellness Center Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.