Provider Demographics
NPI:1831344522
Name:LIFE CYCLE SERVICES, LLC
Entity type:Organization
Organization Name:LIFE CYCLE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HONEYCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, PHD
Authorized Official - Phone:410-466-4918
Mailing Address - Street 1:259 VILLAGE SQUARE II
Mailing Address - Street 2:VILLAGE OF CROSS KEYS
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210
Mailing Address - Country:US
Mailing Address - Phone:410-466-4918
Mailing Address - Fax:
Practice Address - Street 1:259 VILLAGE SQUARE II
Practice Address - Street 2:VILLAGE OF CROSS KEYS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210
Practice Address - Country:US
Practice Address - Phone:410-466-4918
Practice Address - Fax:410-323-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD073661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty