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General NPI Number Information
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NPI Number | 1992199673
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Entity Type | Organization
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Legal Business Name | SUGAR RIVER CARE COUNSELING AND CONSULTATION PLLC
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 24 OPERA HOUSE SQ SUITE 308, BOX 25
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City | CLAREMONT
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State | NH
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Zip | 03743-5408
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Country | US
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Telephone | 603-287-8269
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Fax | 603-504-6249
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Provider Business Mailing Address
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Address Line | 24 OPERA HOUSE SQ SUITE 308, BOX 25
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City | CLAREMONT
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State | NH
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Zip | 03743-5408
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Country | US
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Telephone | 603-287-8269
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Fax | 603-504-6249
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Authorized Official
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Title or Position | CLINICIAN/OWNER
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Name | MRS. SARA BETH POISSON
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Credential | MA, LCMHC, MLADC
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Telephone | 603-287-8269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | NH
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Taxonomy #2
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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 | NH
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