Healthcare Provider Details
I. General information
NPI: 1710437066
Provider Name (Legal Business Name): MOUNTAIN WELLNESS ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2016
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
163 WASHINGTON ST
KEENE NH
03431-3131
US
IV. Provider business mailing address
163 WASHINGTON ST
KEENE NH
03431-3131
US
V. Phone/Fax
- Phone: 603-283-0195
- Fax: 603-283-0197
- Phone: 603-283-0195
- Fax: 603-283-0197
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MEGHAN
ESTEY
Title or Position: CEO & PSYCHOLOGIST
Credential: PSY.D.
Phone: 603-283-0195