Provider Demographics
NPI:1629495106
Name:LIVEWELL COUNSELING
Entity Type:Organization
Organization Name:LIVEWELL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:POULIOT
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-209-6137
Mailing Address - Street 1:217 OLD HOMESTEAD HWY
Mailing Address - Street 2:SUITE I
Mailing Address - City:SWANZEY
Mailing Address - State:NH
Mailing Address - Zip Code:03446-2140
Mailing Address - Country:US
Mailing Address - Phone:603-209-6137
Mailing Address - Fax:603-499-4455
Practice Address - Street 1:217 OLD HOMESTEAD HWY
Practice Address - Street 2:SUITE I
Practice Address - City:SWANZEY
Practice Address - State:NH
Practice Address - Zip Code:03446-2140
Practice Address - Country:US
Practice Address - Phone:603-209-6137
Practice Address - Fax:603-499-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty