Healthcare Provider Details

I. General information

NPI: 1952449977
Provider Name (Legal Business Name): LILAC CITY COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 05/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 ROCHESTER HILL RD.
ROCHESTER NH
03867
US

IV. Provider business mailing address

163 ROCHESTER HILL RD.
ROCHESTER NH
03867
US

V. Phone/Fax

Practice location:
  • Phone: 603-743-4004
  • Fax: 603-743-4115
Mailing address:
  • Phone: 603-743-4004
  • Fax: 603-743-4115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLA CONTARINO
Title or Position: PRESIDENT
Credential: PH D
Phone: 603-332-4004