Provider Demographics
NPI:1306046784
Name:LIFESTRANDS COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:LIFESTRANDS COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PSYD
Authorized Official - Phone:603-924-6400
Mailing Address - Street 1:45 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-2447
Mailing Address - Country:US
Mailing Address - Phone:603-924-6400
Mailing Address - Fax:603-924-6437
Practice Address - Street 1:45 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-2447
Practice Address - Country:US
Practice Address - Phone:603-924-6400
Practice Address - Fax:603-924-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH845103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30424749Medicaid