Healthcare Provider Details

I. General information

NPI: 1154732642
Provider Name (Legal Business Name): ELIAS KOESTER LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON ST
DOVER NH
03820-3848
US

IV. Provider business mailing address

PO BOX 23
NEW DURHAM NH
03855-0023
US

V. Phone/Fax

Practice location:
  • Phone: 603-391-1998
  • Fax:
Mailing address:
  • Phone: 603-391-1998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2518
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: