Healthcare Provider Details

I. General information

NPI: 1760559892
Provider Name (Legal Business Name): CENTER FOR NEW BEGINNINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 COTTAGE ST
LITTLETON NH
03561-4100
US

IV. Provider business mailing address

229 COTTAGE ST
LITTLETON NH
03561-4100
US

V. Phone/Fax

Practice location:
  • Phone: 603-444-6465
  • Fax: 603-444-6233
Mailing address:
  • Phone: 603-444-6465
  • Fax: 603-444-6233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUSAN BOUCHARD
Title or Position: BUSINESS MANAGER
Credential:
Phone: 603-444-6465