Healthcare Provider Details

I. General information

NPI: 1619702990
Provider Name (Legal Business Name): KACY CHIACHIO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 MIDDLE ST
LANCASTER NH
03584-3508
US

IV. Provider business mailing address

173 MIDDLE ST
LANCASTER NH
03584-3508
US

V. Phone/Fax

Practice location:
  • Phone: 603-788-5075
  • Fax:
Mailing address:
  • Phone: 603-788-5075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberPMH02260021
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: