Healthcare Provider Details

I. General information

NPI: 1629620976
Provider Name (Legal Business Name): ST. LOUISE DE MARILLAC COUNSELING MINISTRIES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SANBORN RD STE 4A
LONDONDERRY NH
03053-2362
US

IV. Provider business mailing address

PO BOX 142
GOFFSTOWN NH
03045-0142
US

V. Phone/Fax

Practice location:
  • Phone: 603-404-6296
  • Fax: 855-614-4325
Mailing address:
  • Phone: 603-404-6296
  • Fax: 855-614-4325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YUNIESKA TRUJILLO-RAMIREZ
Title or Position: OWNER
Credential: LICSW
Phone: 603-404-6296