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NPI Code Detail

MEDICARE: MR. JOSEPH M VIANA CRC, LCPC, LCMHC

MEDICARE:  MR. JOSEPH M VIANA  CRC, LCPC, LCMHC
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
1101YM0800XMental Health Counselor639NH
2101YP2500XProfessional CounselorCC2364ME

General Provider Information

NPI Number : 1831373174
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH M VIANA CRC, LCPC, LCMHC
Provider Business Mailing Address
First Line : 120 RABBIT RUN RD
Second Line :
City : MADISON
State : NH
Zip : 03849-5743
Country : US
Telephone Number : 603-367-8418
Fax Number :
Provider Business Practice Location Address
First Line : 448 WHITE MOUNTAIN HWY
Second Line :
City : TAMWORTH
State : NH
Zip : 03886-4626
Country : US
Telephone Number : 603-539-7451
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2007
Last Update Date : 12/21/2007

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Directions to “ MR. JOSEPH M VIANA CRC, LCPC, LCMHC” Practice Location

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