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DIVERSIFIED LIFESTYLE SERVICES NPI 1205213527


NPI Information

NPI: 1205213527
Provider Name: DIVERSIFIED LIFESTYLE SERVICES

Doing Business As: DIVERSIFIED LIFESTYLE SERVICES

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
1300 I ST NW
SUITE 400E
WASHINGTON, DC
ZIP 20005
Phone: (301) 804-8279
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DIVERSIFIED LIFESTYLE SERVICES is a counselor in Washington, DC. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. DIVERSIFIED LIFESTYLE SERVICES NPI is 1205213527. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Diversified Lifestyle Services.

The provider's business location address is:

1300 I ST NW
SUITE 400E
WASHINGTON, DC
ZIP 20005-314
Phone: (301) 804-8279

The provider's authorized official is Antoinette Lancaster .
The authorized official title is Executive Director and has the following contact phone number (202) 239-5563.

The enumeration date for this NPI number is 5/6/2015 and was last updated on 12/10/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)CACII1131DISTRICT OF COLUMBIANo
2101Y00000XCounselorPRC14152DISTRICT OF COLUMBIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1755104500MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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