=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174912265
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ERIN FOLEY, MS, MLADC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2015
-----------------------------------------------------
Last Update Date | 01/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 370 MAIN STREET SECOND FLOOR
-----------------------------------------------------
City | NEW LONDON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-526-2256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 992 ROUTE 114
-----------------------------------------------------
City | BRADFORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03221-6218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-526-2256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ERIN FOLEY
-----------------------------------------------------
Credential | MLADC
-----------------------------------------------------
Telephone | 603-526-2256
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 0570
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------