MEDICARE: DR. ROBERT C MCCOUL PSYD, LCMHC

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	101YM0800X	Mental Health Counselor	205	NH

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	:	1750594396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT C MCCOUL PSYD, LCMHC

Provider Business Mailing Address
First Line	:	25 COUNTRY CLUB RD
Second Line	:	#702
City	:	GILFORD
State	:	NH
Zip	:	03249-6977
Country	:	US
Telephone Number	:	603-527-0868
Fax Number	:	603-528-2176

Provider Business Practice Location Address
First Line	:	25 COUNTRY CLUB RD
Second Line	:	#702
City	:	GILFORD
State	:	NH
Zip	:	03249-6977
Country	:	US
Telephone Number	:	603-527-0868
Fax Number	:	603-528-2176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	02/17/2009

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