Provider Demographics
NPI:1285412023
Name:BE HEARD LIVE WELL LLC
Entity type:Organization
Organization Name:BE HEARD LIVE WELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KASSANDRA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:LAROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:401-323-4288
Mailing Address - Street 1:12704 FOUND STONE RD APT 203
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6937
Mailing Address - Country:US
Mailing Address - Phone:401-323-4288
Mailing Address - Fax:
Practice Address - Street 1:12704 FOUND STONE RD APT 203
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6937
Practice Address - Country:US
Practice Address - Phone:401-323-4288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health