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General NPI Number Information
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NPI Number | 1689916645
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Entity Type | Organization
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Legal Business Name | LIVEWELL THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 03/17/2013
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 7520 MAIN ST SUITE 101
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City | SYKESVILLE
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State | MD
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Zip | 21784-7525
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Country | US
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Telephone | 443-842-6200
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Fax | 443-842-6200
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Provider Business Mailing Address
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Address Line | 7520 MAIN ST SUITE 101
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City | SYKESVILLE
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State | MD
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Zip | 21784-7525
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Country | US
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Telephone | 443-842-6200
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Fax | 443-842-6200
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AUDREY ROSE SCHEERER
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Credential | M.ED., NCC, LGPC
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Telephone | 443-842-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGP4688
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License Number State | MD
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