Healthcare Provider Details

I. General information

NPI: 1275437931
Provider Name (Legal Business Name): SARA KELLEY LMHC, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 WOODBURY AVE STE 1
NEWINGTON NH
03801-7854
US

IV. Provider business mailing address

4 LISA AVE
RAYMOND NH
03077-2040
US

V. Phone/Fax

Practice location:
  • Phone: 603-236-9432
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6643
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5752
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: