Healthcare Provider Details

I. General information

NPI: 1710778592
Provider Name (Legal Business Name): LAKESIDE COUNSELING AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 LILAC LN
EAST WAKEFIELD NH
03830-3169
US

IV. Provider business mailing address

19 LILAC LN
EAST WAKEFIELD NH
03830-3169
US

V. Phone/Fax

Practice location:
  • Phone: 603-307-0817
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELYSE SCHAPPERT
Title or Position: THERAPIST/OWNER AND OPERATOR
Credential: LCSW
Phone: 603-307-0817