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NPI Code Detail

MEDICARE: LIVE.BALANCED.LIFE.LLC

MEDICARE: LIVE.BALANCED.LIFE.LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2261QM0855XAdolescent and Children Mental Health Clinic/Center
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1801757232
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVE.BALANCED.LIFE.LLC
Provider Business Mailing Address
First Line : 6339 TEN OAKS RD STE 300
Second Line :
City : CLARKSVILLE
State : MD
Zip : 21029-1155
Country : US
Telephone Number : 443-904-1817
Fax Number : 410-639-5246
Provider Business Practice Location Address
First Line : 6339 TEN OAKS RD STE 300
Second Line :
City : CLARKSVILLE
State : MD
Zip : 21029-1155
Country : US
Telephone Number : 443-904-1817
Fax Number : 410-639-5246
Authorized Official
Title or Position : CEO
Name : CHRISTINE N WILLIAMS
Credential : LCPC
Telephone Number : 443-904-1817
Provider Enumeration Date : 11/24/2025
Last Update Date : 05/05/2026

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Practice Location Address:
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1811483761 — LIVE.BALANCED.LIFE.LLC
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1598564759 — SHEEBA KALAISELVI ABRAHAM
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1144181561 — LIVE.BALANCED.LIFE.LLC
Practice Location Address:
6339 TEN OAKS RD STE 300
CLARKSVILLE, MD
21029-1155
Practice Phone: 443-904-1817
Practice Fax: 410-639-5246

Directions to “LIVE.BALANCED.LIFE.LLC ” Practice Location

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