Healthcare Provider Details
I. General information
NPI: 1538394747
Provider Name (Legal Business Name): AMHERST PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2009
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27 ROUTE 101A UNIT 3
AMHERST NH
03031-2739
US
IV. Provider business mailing address
27 ROUTE 101A UNIT 3
AMHERST NH
03031-2739
US
V. Phone/Fax
- Phone: 603-769-3114
- Fax: 603-769-3115
- Phone: 603-769-3114
- Fax: 603-769-3115
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | 967 |
| License Number State | NH |
VIII. Authorized Official
Name: DR.
DEBORAH
J
LEVASSEUR
Title or Position: OWNER
Credential: PH.D.
Phone: 603-769-3114