Provider Demographics
NPI:1073146072
Name:VIAFORA, DAVID PAUL (LICSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:VIAFORA
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 GILSUM MINE RD
Mailing Address - Street 2:
Mailing Address - City:ALSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03602-3925
Mailing Address - Country:US
Mailing Address - Phone:603-499-1323
Mailing Address - Fax:
Practice Address - Street 1:655 GILSUM MINE RD
Practice Address - Street 2:
Practice Address - City:ALSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03602-3925
Practice Address - Country:US
Practice Address - Phone:603-499-1323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH28461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical