Healthcare Provider Details

I. General information

NPI: 1912410127
Provider Name (Legal Business Name): LIFE ARTS INTEGRATIVE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N EGREMONT RD
GREAT BARRINGTON MA
01230-1926
US

IV. Provider business mailing address

130 N EGREMONT ROAD
ALFORD MA
01230
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-2452
  • Fax:
Mailing address:
  • Phone: 413-644-6440
  • Fax: 800-504-5869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number1477
License Number StateMA

VIII. Authorized Official

Name: MS. ANNIE BARRY KAY
Title or Position: CEO DIETITIAN
Credential: RDN C-IAYT
Phone: 413-644-6440