Healthcare Provider Details

I. General information

NPI: 1598360752
Provider Name (Legal Business Name): ENSO COUNSELING GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 08/18/2024
Certification Date: 08/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARBERRY LN
CONCORD NH
03301-2417
US

IV. Provider business mailing address

PO BOX 4041
CONCORD NH
03302-4041
US

V. Phone/Fax

Practice location:
  • Phone: 617-819-0914
  • Fax:
Mailing address:
  • Phone:
  • 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. SCOT WILSON
Title or Position: PARTNER
Credential: LCMHC
Phone: 978-704-1861