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General NPI Number Information
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NPI Number | 1437955978
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Entity Type | Organization
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Legal Business Name | MASSEY MENTAL HEALTH LLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 6 CHENELL DR STE 100
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City | CONCORD
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State | NH
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Zip | 03301-8514
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Country | US
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Telephone | 203-767-1553
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Fax |
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Provider Business Mailing Address
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Address Line | 3 DERRY WAY APT 34
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City | DERRY
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State | NH
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Zip | 03038-2158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL MENTAL HEALTH COUNSELOR
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Name | ANGELA DEGENOVA
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Credential | LCMHC
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Telephone | 203-767-1553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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