Provider Demographics
NPI:1639805849
Name:LIFE LOVE & PERSPECTIVE COUNSELING LLC
Entity Type:Organization
Organization Name:LIFE LOVE & PERSPECTIVE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KARLISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-507-7213
Mailing Address - Street 1:1250 CONNECTICUT AVE NW STE 700
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2657
Mailing Address - Country:US
Mailing Address - Phone:202-913-5318
Mailing Address - Fax:
Practice Address - Street 1:6700 ALEXANDER BELL DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2105
Practice Address - Country:US
Practice Address - Phone:410-507-7213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000OtherWE HAVE NOT APPLIED WITH INSURERS' YET