Healthcare Provider Details

I. General information

NPI: 1861905549
Provider Name (Legal Business Name): TRANSITIONS AND LOSS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2017
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 HARVEY LN
EPPING NH
03042-1705
US

IV. Provider business mailing address

11 HARVEY LN
EPPING NH
03042-1705
US

V. Phone/Fax

Practice location:
  • Phone: 603-496-6070
  • Fax: 603-232-3079
Mailing address:
  • Phone: 603-496-6070
  • Fax: 603-232-3079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEE DIETER
Title or Position: BILLING MANAGER
Credential:
Phone: 603-714-0870