Organization Active NPI

Life Talk Therapy LLC

  • Mental Health Occupational Therapist
  • Severn, MD
National Provider Identifier
1932807609
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Occupational TherapistTaxonomy code 225XM0800X
Legal business name
LIFE TALK THERAPY LLC
Practice address
825 Janet Dale LN
Severn, MD 21144-2789
Phone
(410) 980-3163
Fax
(410) 969-2958
NPI assigned
Feb 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Ms. Alice Rita Hunley, LCPCNPI 1801129630
Title
Owner/Therapist
Phone
(410) 980-3163

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
Mental Health Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225XM0800X Primary

Addresses

Primary practice location

825 Janet Dale LN
Severn, MD 21144-2789

Mailing address

825 Janet Dale LN
Severn, MD 21144-2789
Phone (410) 980-3163

Other identifiers 1

IdentifierTypeStateIssuer
572015000MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250617003595 MD Part B Supplier - Clinic/Group Practice 0941711832 Receives reassigned benefits from 1 practitioner
Practice locations: Fort George G Meade, MD

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": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1932807609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 JANET DALE LN",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211442789",
            "telephone_number": "410-980-3163",
            "fax_number": "410-969-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 JANET DALE LN",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211442789",
            "telephone_number": "410-980-3163",
            "fax_number": "410-969-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TALK THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "HUNLEY",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "RITA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "410-980-3163",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "572015000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severn, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.