Organization Active NPI

Live Free Therapy LLC

  • Mental Health Counselor
  • Columbia, MD
National Provider Identifier
1962162180
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIVE FREE THERAPY LLC
Doing business as
Live Free Therapy LLC
Practice address
10632 Little Patuxent Pkwy Ste 309
Columbia, MD 21044-6294
Phone
(443) 313-6350
Fax
(443) 283-4136
NPI assigned
Dec 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Authorized official

Name
JM Jenkins
Title
Owner
Phone
(443) 313-6350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

10632 Little Patuxent Pkwy Ste 309
Columbia, MD 21044-6294

Mailing address

10632 Little Patuxent Pkwy Ste 309
Columbia, MD 21044-6294
Phone (443) 313-6350

Other names 1

  • Live Free Therapy LLC Doing business as

National Provider Directory

National Provider Directory

Locations

10632 Little Patuxent Pkwy
Ste 309
Columbia, MD 21044
Phone (443) 313-6350

Practitioners & affiliated clinicians

Practitioners 2

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": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1962162180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY STE 309",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446294",
            "telephone_number": "443-313-6350",
            "fax_number": "443-283-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY STE 309",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446294",
            "telephone_number": "443-313-6350",
            "fax_number": "443-283-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE FREE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-313-6350"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live Free Therapy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.