MEDICARE: EXETER PSYCHOLOGICAL ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1548217656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXETER PSYCHOLOGICAL ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	370 PORTSMOUTH AVE STE 7
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840-2252
Country	:	US
Telephone Number	:	603-772-2187
Fax Number	:	603-772-0477

Provider Business Practice Location Address
First Line	:	370 PORTSMOUTH AVE STE 7
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840
Country	:	US
Telephone Number	:	603-772-2187
Fax Number	:	603-772-0477

Authorized Official
Title or Position	:	VICE PRESIDENT/PROVIDER
Name	:	DEBORAH H. HAMILTON
Credential	:	LICSW
Telephone Number	:	603-692-4060

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	06/11/2019

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