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NPI 1710778592

NPI 1710778592 : LAKESIDE COUNSELING AND WELLNESS LLC : EAST WAKEFIELD, NH

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General NPI Number Information
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    NPI Number           |    1710778592
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    Entity Type          |    Organization 
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    Legal Business Name  |    LAKESIDE COUNSELING AND WELLNESS LLC 
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Dates
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    Enumeration Date     |    05/13/2025
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    Last Update Date     |    05/28/2025
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Provider Practice Location Address
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    Address Line         |    19 LILAC LN 
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    City                 |    EAST WAKEFIELD
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    State                |    NH
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    Zip                  |    03830-3169
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    Country              |    US
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    Telephone            |    603-307-0817
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    19 LILAC LN 
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    City                 |    EAST WAKEFIELD
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    State                |    NH
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    Zip                  |    03830-3169
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    THERAPIST/OWNER AND OPERATOR
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    Name                 |     ELYSE  SCHAPPERT 
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    Credential           |    LCSW
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    Telephone            |    603-307-0817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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