Healthcare Provider Details

I. General information

NPI: 1417833435
Provider Name (Legal Business Name): UPPER VALLEY PSYCHIATRY P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 LEBANON ST STE 39
HANOVER NH
03755-2158
US

IV. Provider business mailing address

3 LEBANON ST STE 39
HANOVER NH
03755-2196
US

V. Phone/Fax

Practice location:
  • Phone: 802-526-4810
  • Fax: 603-448-0661
Mailing address:
  • Phone: 802-526-4810
  • Fax: 603-448-0661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CASSIE A KOSAREK
Title or Position: OWNER
Credential: MD
Phone: 802-526-4810