Healthcare Provider Details

I. General information

NPI: 1306913447
Provider Name (Legal Business Name): LAURA AMY BLODGETT LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA AMY DESCHENES LICSW

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DARTMOUTH HITCHCOCK - PSYCHIATRY
LEBANON NH
03756
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-6150
  • Fax: 603-640-1228
Mailing address:
  • Phone: 603-650-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1332
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: