Healthcare Provider Details

I. General information

NPI: 1841561602
Provider Name (Legal Business Name): ERIC J STANLEY LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 PLEASANT STREET PSYCHIATRY
CONCORD NH
03301
US

IV. Provider business mailing address

253 PLEASANT ST
CONCORD NH
03301-7560
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-6150
  • Fax:
Mailing address:
  • Phone: 603-650-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1727
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: