MEDICARE: THE COUNSELING CENTER OF NASHUA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP2500X	Professional Counselor
3	103G00000X	Clinical Neuropsychologist
4	103T00000X	Psychologist
5	103TA0700X	Adult Development & Aging Psychologist
6	103TC1900X	Counseling Psychologist
7	103TC2200X	Clinical Child & Adolescent Psychologist
8	103TF0000X	Family Psychologist
9	103TF0200X	Forensic Psychologist
10	1041C0700X	Clinical Social Worker
11	106H00000X	Marriage & Family Therapist
12	103TC0700X	Clinical Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144275389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE COUNSELING CENTER OF NASHUA INC

Provider Business Mailing Address
First Line	:	1 MAIN ST
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03064-2716
Country	:	US
Telephone Number	:	603-883-0005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MAIN ST
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03064
Country	:	US
Telephone Number	:	603-883-0005
Fax Number	:	603-883-0007

Authorized Official
Title or Position	:	CHIEF LEGAL OFFICER
Name	:	RYAN PARDO
Credential	:
Telephone Number	:	425-279-8500

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	10/23/2023

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