| Live.balanced.life.llc | |
|
6339 Ten Oaks Rd Ste 300 Clarksville MD 21029-1155 | |
| (443) 904-1817 | |
| (410) 639-5246 |
| Full Name | Live.balanced.life.llc |
|---|---|
| Speciality | Counselor |
| Location | 6339 Ten Oaks Rd Ste 300, Clarksville, Maryland |
| Authorized Official Name and Position | Christine Nadine Williams (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 2407053086 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live.balanced.life.llc 5305 Village Center Dr Ste 176 Columbia MD 21044-2382 Ph: (240) 705-3086 | Live.balanced.life.llc 6339 Ten Oaks Rd Ste 300 Clarksville MD 21029-1155 Ph: (443) 904-1817 |
| NPI Number | 1811483761 |
|---|---|
| Provider Enumeration Date | 07/03/2018 |
| Last Update Date | 11/08/2024 |
| Certification Date | 11/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811483761 | NPI | - | NPPES |
| 989010600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LC6864 (Maryland) | Primary |
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