Healthcare Provider Details

I. General information

NPI: 1396482501
Provider Name (Legal Business Name): LIFETIME IMPROVEMENT COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 PHILLIP MORRIS DR
SALISBURY MD
21804-1923
US

IV. Provider business mailing address

6626 SNOW HILL RD
SNOW HILL MD
21863-3302
US

V. Phone/Fax

Practice location:
  • Phone: 443-783-5225
  • Fax:
Mailing address:
  • Phone: 443-783-5225
  • Fax: 410-753-8655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SEAN JUDE ALVARADO
Title or Position: LCPC
Credential:
Phone: 443-783-5225