Provider Demographics
NPI:1417563453
Name:SERVICES ENRICHING LIFE'S FUTURE COUNSELING LLC
Entity Type:Organization
Organization Name:SERVICES ENRICHING LIFE'S FUTURE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKITA
Authorized Official - Middle Name:COX
Authorized Official - Last Name:LAWS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:443-756-3101
Mailing Address - Street 1:935 CHARDRIE DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-7655
Mailing Address - Country:US
Mailing Address - Phone:443-756-3101
Mailing Address - Fax:443-345-4483
Practice Address - Street 1:413 W BEL AIR AVE STE 103
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2424
Practice Address - Country:US
Practice Address - Phone:443-756-3101
Practice Address - Fax:443-345-4483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD019683500Medicaid