=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518752039
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARIS AWALT, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2025
-----------------------------------------------------
Last Update Date | 04/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 CHENELL DR STE 100
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03301-8514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-219-4528
-----------------------------------------------------
Fax | 603-219-4528
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 CHENELL DR STE 100
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03301-8514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-219-4528
-----------------------------------------------------
Fax | 603-219-4528
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICIAN
-----------------------------------------------------
Name | PARIS SUSANNAH AWALT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 603-219-4528
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------