Healthcare Provider Details

I. General information

NPI: 1356520589
Provider Name (Legal Business Name): ERIN E. GILLIGAN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 01/09/2025
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 JOE ENGLISH RD.
NEW BOSTON NH
03070-0382
US

IV. Provider business mailing address

PO BOX 26
NEW BOSTON NH
03070
US

V. Phone/Fax

Practice location:
  • Phone: 603-497-7866
  • Fax:
Mailing address:
  • Phone: 603-497-7866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: