Healthcare Provider Details

I. General information

NPI: 1265448880
Provider Name (Legal Business Name): JOANNE C. DEVLIN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 OLD ROLLINSFORD RD SUITE 302
DOVER NH
03820-2868
US

IV. Provider business mailing address

789 CENTRAL AVE
DOVER NH
03820-2526
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-9200
  • Fax:
Mailing address:
  • Phone: 603-742-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number604
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC2298
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: