Healthcare Provider Details

I. General information

NPI: 1427985258
Provider Name (Legal Business Name): SOMA MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CONSTITUTION DR UNIT 111
BEDFORD NH
03110-6042
US

IV. Provider business mailing address

39 FOCH ST
MANCHESTER NH
03102-1112
US

V. Phone/Fax

Practice location:
  • Phone: 207-536-8249
  • Fax:
Mailing address:
  • Phone: 207-536-8249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. ZACHARY DEWITT
Title or Position: OWNER/CLINICIAN
Credential: LCMHC
Phone: 207-536-8249