Healthcare Provider Details

I. General information

NPI: 1063015121
Provider Name (Legal Business Name): CHRISTINE ALBERT COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/22/2020
Certification Date: 11/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 DOVER POINT RD
DOVER NH
03820-9145
US

IV. Provider business mailing address

34 DOVER POINT RD
DOVER NH
03820-9145
US

V. Phone/Fax

Practice location:
  • Phone: 603-676-9638
  • Fax:
Mailing address:
  • Phone: 603-676-9638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3103690
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer

VIII. Authorized Official

Name: MS. CHRISTINE ALBERT
Title or Position: OWNER
Credential: LICSW
Phone: 603-767-9638