Provider Demographics
NPI:1033855671
Name:CHERYL A CARROLL
Entity Type:Organization
Organization Name:CHERYL A CARROLL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LABATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-305-8520
Mailing Address - Street 1:3B TAGGART DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5592
Mailing Address - Country:US
Mailing Address - Phone:978-496-9276
Mailing Address - Fax:
Practice Address - Street 1:3B TAGGART DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5592
Practice Address - Country:US
Practice Address - Phone:978-496-9276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty