Healthcare Provider Details

I. General information

NPI: 1730765744
Provider Name (Legal Business Name): MENTAL HEALTHWORKS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2021
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 NORTHEASTERN BLVD STE 240A
NASHUA NH
03062-3139
US

IV. Provider business mailing address

11 NORTHEASTERN BLVD STE 240A
NASHUA NH
03062-3139
US

V. Phone/Fax

Practice location:
  • Phone: 603-417-4378
  • Fax: 867-292-6142
Mailing address:
  • Phone: 603-417-4378
  • Fax: 867-292-6142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CARA-JEAN DONAGHEY
Title or Position: MANAGER
Credential: ANP-BC, PMHNP-BC
Phone: 603-417-4378