Healthcare Provider Details

I. General information

NPI: 1215500475
Provider Name (Legal Business Name): GABRIELLE CASEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 UNION ST
MANCHESTER NH
03103-5563
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: 603-625-0010
  • Fax: 603-625-0075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5919
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: