Healthcare Provider Details

I. General information

NPI: 1821163247
Provider Name (Legal Business Name): JENNIFER A BOIS LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 12/11/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 BROAD ST STE 1511
NASHUA NH
03063-3205
US

IV. Provider business mailing address

154 BROAD ST STE 1511
NASHUA NH
03063-3205
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-5551
  • Fax: 603-577-5576
Mailing address:
  • Phone: 603-577-5551
  • Fax: 603-577-5576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number665
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number629
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: