Healthcare Provider Details

I. General information

NPI: 1891652442
Provider Name (Legal Business Name): JOHN C. JAMISON II LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 GRANITE ST FL 3
MANCHESTER NH
03102-4000
US

IV. Provider business mailing address

461 SUGAR HOUSE HILL RD
GUILFORD VT
05301-8137
US

V. Phone/Fax

Practice location:
  • Phone: 603-273-5566
  • Fax:
Mailing address:
  • Phone: 540-797-1506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5850
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: