Healthcare Provider Details

I. General information

NPI: 1336060078
Provider Name (Legal Business Name): NICOLE PAULINE BOUCHARD LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE PAULINE HALLEE

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 ROCKINGHAM RD
LONDONDERRY NH
03053-2170
US

IV. Provider business mailing address

141 UNION ST
MANCHESTER NH
03103-5563
US

V. Phone/Fax

Practice location:
  • Phone: 603-625-0010
  • Fax: 603-625-0075
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5799
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: