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General NPI Number Information
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NPI Number | 1588340749
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE COLLABORATIVE CARE LLC
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 117 MANCHESTER ST STE 5A
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City | CONCORD
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State | NH
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Zip | 03301-5101
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Country | US
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Telephone | 603-606-9357
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Fax | 603-217-2075
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Provider Business Mailing Address
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Address Line | 117 MANCHESTER ST STE 5A
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City | CONCORD
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State | NH
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Zip | 03301-5101
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Country | US
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Telephone | 603-606-9357
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Fax | 603-217-2075
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN GIBSON
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Credential | PHARMD, BCPP
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Telephone | 603-606-9357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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