Provider Demographics
NPI:1386860658
Name:LIFE DIRECTIONS
Entity Type:Organization
Organization Name:LIFE DIRECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PICK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-C, EMI, SA
Authorized Official - Phone:301-668-1689
Mailing Address - Street 1:124 N COURT ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5416
Mailing Address - Country:US
Mailing Address - Phone:301-668-1689
Mailing Address - Fax:301-668-1910
Practice Address - Street 1:124 N COURT ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5416
Practice Address - Country:US
Practice Address - Phone:301-668-1689
Practice Address - Fax:301-668-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty