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General NPI Number Information
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NPI Number | 1568197184
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Entity Type | Organization
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Legal Business Name | NORTHERN TRAILS COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 20 W PARK ST STE 203
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City | LEBANON
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State | NH
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Zip | 03766-1378
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Country | US
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Telephone | 603-724-1377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 445
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City | SUNAPEE
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State | NH
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Zip | 03782-0445
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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 | MEMBER
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Name | ERIN D TERRY
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Credential | LCMHC, LCPC
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Telephone | 802-478-0287
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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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