Healthcare Provider Details

I. General information

NPI: 1043826902
Provider Name (Legal Business Name): TREE OF LIFE PSYCHOTHERAPY AND COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 PALOMINO LN STE 703
BEDFORD NH
03110-6448
US

IV. Provider business mailing address

8 TIMBERLANE DR
BEDFORD NH
03110-5740
US

V. Phone/Fax

Practice location:
  • Phone: 603-325-5459
  • Fax:
Mailing address:
  • Phone: 162-368-7831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER LYNN FRIEDMAN
Title or Position: OWNER AND PSYCHOTHERAPIST
Credential: LCMHC
Phone: 603-325-5459