Healthcare Provider Details

I. General information

NPI: 1184558595
Provider Name (Legal Business Name): NORTHERN ROOTS COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 PLEASANT ST
CONCORD NH
03301-2547
US

IV. Provider business mailing address

169 PLEASANT ST
CONCORD NH
03301-2547
US

V. Phone/Fax

Practice location:
  • Phone: 603-812-3201
  • Fax:
Mailing address:
  • Phone:
  • 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: LEAH DUBOIS
Title or Position: OWNER
Credential: LICSW
Phone: 603-812-3201