Healthcare Provider Details

I. General information

NPI: 1023207438
Provider Name (Legal Business Name): SCOTT S. PARENT MHRT-C & LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PAGE HILL RD
BERLIN NH
03570-3531
US

IV. Provider business mailing address

173 MIDDLE ST
LANCASTER NH
03584-3508
US

V. Phone/Fax

Practice location:
  • Phone: 603-342-5000
  • Fax: 603-752-6062
Mailing address:
  • Phone: 603-788-5029
  • Fax: 603-788-5607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC4049
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC4848
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: