Organization Active NPI

Life Transformations, LLC

  • Psychologist
  • Newburyport, MA
National Provider Identifier
1932386596
Registry record updated Jan 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5320 Issued in OH
Legal business name
LIFE TRANSFORMATIONS, LLC
Practice address
21 Pleasant St Ste 235
Newburyport, MA 01950-2623
Phone
(802) 359-9139
Fax
(802) 359-3468
NPI assigned
Jan 25, 2008
Last updated
Jan 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2019

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

Authorized official

Name
Dr. Holly R. Counts, PSY.D.
Title
Owner
Phone
(802) 359-9139

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E7971 OH
Psychologist 103T00000X 5320 OH Primary

Addresses

Primary practice location

21 Pleasant St Ste 235
Newburyport, MA 01950-2623

Mailing address

PO Box 15
Newburyport, MA 01950-0015
Phone (802) 359-9139

Other identifiers 1

IdentifierTypeStateIssuer
2217863MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190125002211 MA Part B Supplier - Clinic/Group Practice 2264519628 Receives reassigned benefits from 1 practitioner
Practice locations: Newburyport, MA

National Provider Directory

National Provider Directory

Locations

21 Pleasant St
Ste 235
Newburyport, MA 01950
Phone (802) 359-9139

85 N Main St
Ste 230
White River Junction, VT 05001
Phone (802) 280-1900

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547856000000",
    "number": "1932386596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019500015",
            "telephone_number": "802-359-9139",
            "fax_number": "802-359-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PLEASANT ST STE 235",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502623",
            "telephone_number": "802-359-9139",
            "fax_number": "802-359-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TRANSFORMATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2019-01-19",
        "status": "A",
        "authorized_official_last_name": "COUNTS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-359-9139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E7971",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2217863",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.