Healthcare Provider Details

I. General information

NPI: 1376660381
Provider Name (Legal Business Name): JANET P CLEARY MA, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 PARTRIDGEBERRY LANE
SWANZEY NH
03446
US

IV. Provider business mailing address

PO BOX 10125
SWANZEY NH
03446
US

V. Phone/Fax

Practice location:
  • Phone: 603-209-1526
  • Fax: 603-283-0197
Mailing address:
  • Phone: 603-209-1526
  • Fax: 603-283-0197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0607
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number849
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: