MEDICARE: MR. DAVID CANTAGALLO LCMHC,LADAC

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	101YM0800X	Mental Health Counselor	204	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396950721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID CANTAGALLO LCMHC,LADAC

Provider Business Mailing Address
First Line	:	18 SUNAPEE HEIGHTS CT
Second Line	:
City	:	SUNAPEE
State	:	NH
Zip	:	03782-2927
Country	:	US
Telephone Number	:	603-763-9369
Fax Number	:	603-763-9369

Provider Business Practice Location Address
First Line	:	18 SUNAPEE HEIGHTS CT
Second Line	:
City	:	SUNAPEE
State	:	NH
Zip	:	03782-2927
Country	:	US
Telephone Number	:	603-763-9369
Fax Number	:	603-763-9369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	07/09/2007

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