Healthcare Provider Details

I. General information

NPI: 1225684590
Provider Name (Legal Business Name): SHRUTI JOSHI M.S., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHRUTI YEDAVE M.S., LPC

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 ROUTE 101 STE 12B
BEDFORD NH
03110-5031
US

IV. Provider business mailing address

25 S RIVER RD STE 307
BEDFORD NH
03110-6716
US

V. Phone/Fax

Practice location:
  • Phone: 603-242-2296
  • Fax:
Mailing address:
  • Phone: 603-242-2296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2373
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: