Lifewalk

Primary specialty

CounselorTaxonomy code 101Y00000X

License

1068 Issued in NH

Legal business name

LIFEWALK

Practice address

19 Washington St
Concord, NH 03301-4341

Phone

(941) 875-4338

NPI assigned

Dec 6, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lori Olson, LCMHC

Title

Psychotherapist

Phone

(941) 875-4338

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1679017966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WASHINGTON ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014341",
            "telephone_number": "941-875-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WASHINGTON ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014341",
            "telephone_number": "941-875-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWALK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "941-875-4338",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "NH",
            "license": "1068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCMHC NUMBER",
            "identifier": "1068",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC NUMBER",
            "identifier": "12533",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12727367",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1003230269",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3098584",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Heller Lewy, M.D.
• Yan Li, M.D.
• Amy Marie Libby, M.S. CCC-SLP
• Samantha Licciardi Gemma
• Life in Bloom Counseling, LLC
• Courtney Jayne Ligor, MCD CCC SLP
• Stacey Lillios, PT
• Jason Lim, M.D.
• Joanne G. Linden, ED.D.
• Jason David Lindner

• Counselor in Concord, NH
• Providers in Concord, NH by specialty
• Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.