Healthcare Provider Details

I. General information

NPI: 1699205294
Provider Name (Legal Business Name): LIVE & LET LIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3549 ELMLEY AVENUE
BALTIMORE MD
21213
US

IV. Provider business mailing address

3549 ELMLEY AVE
BALTIMORE MD
21213-1951
US

V. Phone/Fax

Practice location:
  • Phone: 443-939-7728
  • Fax:
Mailing address:
  • Phone: 443-939-7728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC7872
License Number StateMD

VIII. Authorized Official

Name: MS. VEL HUMBERT
Title or Position: THERAPIST
Credential: LCPC
Phone: 443-939-7728