Provider Demographics
NPI:1104011428
Name:GEAUMONT, ERIC MICHAEL (LCMHC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MICHAEL
Last Name:GEAUMONT
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 438
Mailing Address - Street 2:365 WEST MAIN ST
Mailing Address - City:HILLSBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03242
Mailing Address - Country:US
Mailing Address - Phone:603-464-5599
Mailing Address - Fax:603-464-5549
Practice Address - Street 1:365 WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:NH
Practice Address - Zip Code:03242
Practice Address - Country:US
Practice Address - Phone:603-464-5599
Practice Address - Fax:603-464-5549
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH587101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423766Medicaid