MEDICARE: KAIZEN MENTAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1104619568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAIZEN MENTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	20 FOUNDRY ST FL 2
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-5419
Country	:	US
Telephone Number	:	603-490-0384
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 FOUNDRY ST FL 2
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-5419
Country	:	US
Telephone Number	:	603-490-0384
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRYAN HAAK
Credential	:
Telephone Number	:	603-490-0384

Provider Enumeration Date	:	05/27/2025
Last Update Date	:	04/06/2026

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