Healthcare Provider Details

I. General information

NPI: 1750594396
Provider Name (Legal Business Name): ROBERT C MCCOUL PSYD, LCMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CHENELL DR STE 250
CONCORD NH
03301-8514
US

IV. Provider business mailing address

6 CHENELL DR STE 250
CONCORD NH
03301-8514
US

V. Phone/Fax

Practice location:
  • Phone: 603-513-1598
  • Fax: 603-513-1585
Mailing address:
  • Phone: 603-513-1598
  • Fax: 603-513-1585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number205
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: