MEDICARE: COMMUNITY COUNCIL OF NASHUA NH, INC.

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

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	:	1770588444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY COUNCIL OF NASHUA NH, INC.

Provider Business Mailing Address
First Line	:	100 W PEARL ST
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03060-3343
Country	:	US
Telephone Number	:	603-889-6147
Fax Number	:	603-822-2017

Provider Business Practice Location Address
First Line	:	7 PROSPECT ST
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03060-3921
Country	:	US
Telephone Number	:	603-889-6147
Fax Number	:	603-883-1568

Authorized Official
Title or Position	:	REVENUE CYCLE MANAGER
Name	:	LISA GOGUEN
Credential	:
Telephone Number	:	603-889-6147

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	02/17/2026

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