=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982320081
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIDGET ERIN PARECE-GROGAN MSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2022
-----------------------------------------------------
Last Update Date | 10/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1A COMMONS DR UNIT 5
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-3448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-255-3877
-----------------------------------------------------
Fax | 603-386-6317
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1A COMMONS DR UNIT 5
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-3448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-255-3877
-----------------------------------------------------
Fax | 603-386-6317
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 5106
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------