| Lifestyle Psychiatry And Wellness | |
|
6700 Ridge Rd Ste 1 Rosedale MD 21237-3960 | |
| (973) 964-5107 | |
| Not Available |
| Full Name | Lifestyle Psychiatry And Wellness |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6700 Ridge Rd Ste 1, Rosedale, Maryland |
| Authorized Official Name and Position | Lashire Diegue (OWNER) |
| Authorized Official Contact | 9739645107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestyle Psychiatry And Wellness 202 Blum Ct Unit 1816 Bel Air MD 21014-8572 Ph: () - | Lifestyle Psychiatry And Wellness 6700 Ridge Rd Ste 1 Rosedale MD 21237-3960 Ph: (973) 964-5107 |
| NPI Number | 1952185241 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Medicare PECOS PAC ID | 8224488051 |
|---|---|
| Medicare Enrollment ID | O20231220001398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952185241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Lashire J Diegue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245465871 PECOS PAC ID: 8729221924 Enrollment ID: I20170801002189 |
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