| Lifemark Inc. | |
|
1342 S Division St Ste 401 Salisbury MD 21804-6921 | |
| (443) 859-8584 | |
| (443) 859-8496 |
| Full Name | Lifemark Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1342 S Division St Ste 401, Salisbury, Maryland |
| Authorized Official Name and Position | Marion Travers (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 4438598584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifemark Inc. 1342 S Division St Ste 401 Salisbury MD 21804-6921 Ph: (443) 859-8584 | Lifemark Inc. 1342 S Division St Ste 401 Salisbury MD 21804-6921 Ph: (443) 859-8584 |
| NPI Number | 1982040077 |
|---|---|
| Provider Enumeration Date | 05/15/2013 |
| Last Update Date | 03/15/2023 |
| Certification Date | 03/15/2023 |
| Medicare PECOS PAC ID | 1153635396 |
|---|---|
| Medicare Enrollment ID | O20150803000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982040077 | NPI | - | NPPES |
| 053972400 | Medicaid | MD | |
| 068375200 | Medicaid | MD |
| Provider Name | Mark A Shaffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659314565 PECOS PAC ID: 8820194053 Enrollment ID: I20181214000428 |
| Provider Name | Lynly Ellen Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265989743 PECOS PAC ID: 9234470865 Enrollment ID: I20190409002092 |
| Provider Name | Lisa A Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902315575 PECOS PAC ID: 7517380280 Enrollment ID: I20200714001478 |
| Provider Name | Rachel Boyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821616160 PECOS PAC ID: 4789082314 Enrollment ID: I20211012000603 |
| Provider Name | Ellen Gayle Schwinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265821417 PECOS PAC ID: 9032501747 Enrollment ID: I20220110000032 |
| Provider Name | Lindsay Britt Stallings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891277695 PECOS PAC ID: 9931542875 Enrollment ID: I20240208000706 |
| Provider Name | Tashanika Kimberlee Thomas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487172870 PECOS PAC ID: 1951745934 Enrollment ID: I20240217000568 |
| Provider Name | Brittni Willoughby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629598719 PECOS PAC ID: 4880038306 Enrollment ID: I20240222003299 |
| Provider Name | Janelle Marie Beiler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740519768 PECOS PAC ID: 1557798360 Enrollment ID: I20240223000014 |
| Provider Name | Marion Travers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447526546 PECOS PAC ID: 0446494116 Enrollment ID: I20240226003706 |
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