Provider Demographics
NPI:1083256861
Name:LIFETIME IMPROVEMENT COUNSELING LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:LIFETIME IMPROVEMENT COUNSELING LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:JUDE
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-783-5225
Mailing Address - Street 1:1147 S SALISBURY BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-6865
Mailing Address - Country:US
Mailing Address - Phone:410-251-6371
Mailing Address - Fax:
Practice Address - Street 1:6626 SNOW HILL RD
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-3302
Practice Address - Country:US
Practice Address - Phone:410-251-6371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-12
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDEJ730001OtherCAREFIRST