MEDICARE: LIFEPOINT LEBANON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP1600X	Pastoral Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1982549994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFEPOINT LEBANON

Provider Business Mailing Address
First Line	:	158 N ADAMS AVE
Second Line	:
City	:	LEBANON
State	:	MO
Zip	:	65536-3044
Country	:	US
Telephone Number	:	417-991-2911
Fax Number	:

Provider Business Practice Location Address
First Line	:	158 N ADAMS AVE
Second Line	:
City	:	LEBANON
State	:	MO
Zip	:	65536-3044
Country	:	US
Telephone Number	:	417-991-2911
Fax Number	:

Authorized Official
Title or Position	:	LEAD PASTOR
Name	:	KELLY RHOADES
Credential	:
Telephone Number	:	417-991-2911

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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Directions to “LIFEPOINT LEBANON ” Practice Location

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