Healthcare Provider Details

I. General information

NPI: 1700611902
Provider Name (Legal Business Name): PRACTICAL PSYCHOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 EXECUTIVE PARK DR STE 222
BEDFORD NH
03110-6985
US

IV. Provider business mailing address

3 EXECUTIVE PARK DR STE 222
BEDFORD NH
03110-6985
US

V. Phone/Fax

Practice location:
  • Phone: 603-836-3469
  • Fax:
Mailing address:
  • Phone: 603-836-3469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LOREY DELAP
Title or Position: PRESIDENT/PROVIDER
Credential: LCSW
Phone: 504-291-3898