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General NPI Number Information
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NPI Number | 1548770126
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Entity Type | Organization
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Legal Business Name | PAUL MCKIM
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 10/09/2017
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Provider Practice Location Address
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Address Line | 188 N MAIN ST STE 1OFFICE3
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City | CONCORD
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State | NH
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Zip | 03301-5095
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Country | US
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Telephone | 603-892-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 188 N MAIN ST STE 1OFFICE3
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City | CONCORD
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State | NH
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Zip | 03301-5095
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Country | US
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Telephone | 603-892-4760
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | PAUL MCKIM
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Credential | MA, LCMHC
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Telephone | 603-892-4760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 1249
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License Number State | NH
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