Healthcare Provider Details

I. General information

NPI: 1780984708
Provider Name (Legal Business Name): CHRISTY ANN CHARLESWORTH LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CHENELL DR STE 110
CONCORD NH
03301-8503
US

IV. Provider business mailing address

445 CYPRESS ST STE 8
MANCHESTER NH
03103-3600
US

V. Phone/Fax

Practice location:
  • Phone: 603-883-0005
  • Fax: 603-883-0007
Mailing address:
  • Phone: 603-668-4079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number811
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: