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NPI Code Detail

MEDICARE: COMPREHENSIVE COLLABORATIVE CARE LLC

MEDICARE: COMPREHENSIVE COLLABORATIVE CARE LLC
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
11835P1300XPsychiatric Pharmacist
2103TC0700XClinical Psychologist
3363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1588340749
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE COLLABORATIVE CARE LLC
Provider Business Mailing Address
First Line : 117 MANCHESTER ST STE 5A
Second Line :
City : CONCORD
State : NH
Zip : 03301-5101
Country : US
Telephone Number : 603-606-9357
Fax Number : 603-217-2075
Provider Business Practice Location Address
First Line : 117 MANCHESTER ST STE 5A
Second Line :
City : CONCORD
State : NH
Zip : 03301-5101
Country : US
Telephone Number : 603-606-9357
Fax Number : 603-217-2075
Authorized Official
Title or Position : OWNER
Name : DR. STEPHEN GIBSON
Credential : PHARMD, BCPP
Telephone Number : 603-606-9357
Provider Enumeration Date : 06/23/2023
Last Update Date : 04/08/2026

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Directions to “COMPREHENSIVE COLLABORATIVE CARE LLC ” Practice Location

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