Healthcare Provider Details

I. General information

NPI: 1063329027
Provider Name (Legal Business Name): LIFE ARTS COUNSELING, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W PARK ST STE 379
LEBANON NH
03766-1395
US

IV. Provider business mailing address

2 W PARK ST STE 379
LEBANON NH
03766-1395
US

V. Phone/Fax

Practice location:
  • Phone: 802-478-0113
  • Fax:
Mailing address:
  • Phone: 802-478-0113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLY JO WOODSIDE
Title or Position: OWNER
Credential: LCMHC, CRC
Phone: 802-478-0113