Healthcare Provider Details

I. General information

NPI: 1336258425
Provider Name (Legal Business Name): STEPHANIE LOVERING LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 LOUDON RD BLDG 3
CONCORD NH
03301-5600
US

IV. Provider business mailing address

PO BOX 2032
CONCORD NH
03302-2032
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-0547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number943
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: