Diversified Lifestyle Services

NPI #1255814125 in Waldorf, Maryland

Provider Information

NPI Number: 1255814125
Entity Type: Organization
Organization Name: Diversified Lifestyle Services
Subpart: Yes (part of a larger organization)
Parent Organization: LANCASTER, FRAZIER, AND ASSOCIATES, LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Sep 7, 2018
Last Updated: Dec 10, 2018

Practice Location

Address: 2255 CRAIN HWY STE 102
City: Waldorf
State: Maryland
ZIP Code: 20601-3186
Phone: (301) 804-8279

Authorized Official

Name: DR. ANTOINETTE LANCASTER, EDD, LCPC, NCC, MAC
Title: EXECUTIVE DIRECTOR
Phone: (202) 239-5563

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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