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General NPI Number Information
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NPI Number | 1821182122
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Entity Type | Organization
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Legal Business Name | ATLANTIC BEHAVIORAL MEDICINE INC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 6 CHENELL DR SUITE 250
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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 | 603-513-1598
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Fax | 603-513-1585
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Provider Business Mailing Address
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Address Line | 6 CHENELL DR SUITE 250
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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 | 603-513-1598
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Fax | 603-513-1585
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT C MCCOUL
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Credential | PSYD
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Telephone | 603-513-1598
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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 | 205
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License Number State | NH
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