LEOTA LIFESTAR LLC (NPI# 1598085011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598085011 |
| Entity Type | Organization |
| Organization Name | LEOTA LIFESTAR LLC |
| Practice Address |
75 Thomas Johnson Dr Suite E Frederick MD 21702-4895 |
| Practice Telephone | 2404059059 |
| Practice Fax Number | 4432834038 |
| Mailing Telephone | 2404059059 |
| Mailing Fax Number | 4432834038 |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2010-06-07 |
| Authorized Official Name | MRS. SANDRA E MARLEY (VICE PRESIDENT) |
| Authorized Official Telephone | 2404056865 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
75 THOMAS JOHNSON DR SUITE E |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598768764 | Everett T. Hart | Otolaryngology | 75 Thomas Johnson Dr, Ste B, Frederick, MD 21702-4895 | 2005-05-23 |
| 1811281322 | Jennifer Hair | Genetic Counselor, MS | 75 Thomas Johnson Dr, Suite G, Frederick, MD 21702-4895 | 2011-06-01 |
| 1669764114 | Frederick Foot and Ankle Specialists | Durable Medical Equipment & Medical Supplies | 75 Thomas Johnson Dr, Suite I, Frederick, MD 21702-4895 | 2011-05-03 |
| 1710286190 | Center for Pain Management, LLC | Pain Medicine | 75 Thomas Johnson Dr, Ste C, Frederick, MD 21702-4895 | 2011-03-24 |
| 1669785457 | Frederick Foot & Ankle Surgery Center LLC | Clinic/Center | 75 Thomas Johnson Dr, Suite I, Frederick, MD 21702-4895 | 2010-07-21 |
| 1326351776 | George I Smith | Internal Medicine | 75 Thomas Johnson Dr, Suite F, Frederick, MD 21702-4895 | 2010-07-14 |
| 1417106998 | Family Mri Inc. | Radiology | 75 Thomas Johnson Dr, Suite F, Frederick, MD 21702-4895 | 2008-09-09 |
| 1669669818 | Tuckey and Associates Physical Therapy, LLC | Physical Therapist | 75 Thomas Johnson Dr, Frederick, MD 21702-4895 | 2007-10-02 |
| 1497888226 | Elizabeth Anne Van Dermark | Nurse Practitioner | 75 Thomas Johnson Dr, Suite C, Frederick, MD 21702-4895 | 2007-03-13 |
| 1528191368 | M Jean Giove | Physical Therapist | 75 Thomas Johnson Dr, Suite M, Frederick, MD 21702-4895 | 2007-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| 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. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952875221 | Christina Lavely | Counselor | 142 6th St Unit 3, Frederick, CO 80530-5004 | 2019-01-18 |
| 1891266631 | Connelly Stewart Counseling, LLC | Counselor | 100 N Court St Ste 203, Frederick, MD 21701-5416 | 2018-12-05 |
| 1912475435 | Travis D. Riser | Counselor | 1003 W 7th St Ste 100, Frederick, MD 21701-4131 | 2018-11-02 |
| 1871080481 | Elizabeth Marie Kamnikar | Counselor | 4024 Belgrave Cir, Frederick, MD 21704-7236 | 2018-04-18 |
| 1568900504 | New Market Hanai Ohana, LLC. | Counselor | 30 S Court St, Frederick, MD 21701-5510 | 2017-02-10 |
| 1811294176 | Kendell Elaine Clark | Counselor | 1118 North 13th Street, Frederick, OK 73542-1605 | 2011-02-23 |
| 1932431905 | Angela S. Harrington | Counselor | 422 N 14th St, Frederick, OK 73542-4419 | 2010-02-02 |
| 1174697916 | Kristin L Milne | Counselor | 306 W Patrick St, Frederick, MD 21701-4889 | 2006-11-20 |
| 1528177573 | Jason Michael Barth | Counselor | 263 W Patrick St, Frederick, MD 21701-6942 | 2006-08-30 |
| 1023648334 | Andrew James Campbell | Counselor | 1 W Church St, Frederick, MD 21701-5991 | 2020-01-26 |
| Find all providers in FREDERICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.