OrganizationActive
Life Span Group LLC
NPI 1679390835 · Mental Health Counselor · Baltimore, MD
Provider details
- NPI number
- 1679390835
- Entity type
- Organization
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Latasha Roles, Ceo(443) 208-6156
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
23 Pierside Dr Apt 237
Baltimore, MD 21230-5476
Phone: (443) 208-6156
Street-level locationGet directions
Mailing address
23 Pierside Dr Apt 237
Baltimore, MD 21230-5476
Registry dates
- Enumerated
- 2024-09-20
- Last updated
- 2024-09-20
- Certified
- 2024-09-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.