1083256861 NPI number — LIFETIME IMPROVEMENT COUNSELING

Table of content: (NPI 1083256861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083256861 NPI number — LIFETIME IMPROVEMENT COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFETIME IMPROVEMENT COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083256861
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1147 S SALISBURY BLVD STE 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21801-6865
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-251-6371
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6626 SNOW HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SNOW HILL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21863-3302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-251-6371
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2019

Additional Information

Authorized Official

Authorized Official Last Name:
ALVARADO
Authorized Official First Name:
SEAN
Authorized Official Middle Name:
JUDE
Authorized Official Title or Position:
PROFESSIONAL COUNSELOR
Authorized Official Telephone Number:
443-783-5225

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: EJ730001 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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