Provider Demographics
NPI:1114190899
Name:GAGNE, FELIX P (LCMHC, LADC, CEAP)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:P
Last Name:GAGNE
Suffix:
Gender:M
Credentials:LCMHC, LADC, CEAP
Other - Prefix:
Other - First Name:LUKE
Other - Middle Name:F
Other - Last Name:GAGNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMHC, LADC, CEAP
Mailing Address - Street 1:388 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-4912
Mailing Address - Country:US
Mailing Address - Phone:603-627-1127
Mailing Address - Fax:603-659-0385
Practice Address - Street 1:312 HIGHLANDER WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-7414
Practice Address - Country:US
Practice Address - Phone:603-626-1244
Practice Address - Fax:603-626-1320
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0258101YA0400X
NH466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)