Provider Demographics
NPI:1164519716
Name:STRATTON, JEFFREY (MS LCMHC, MLADC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:STRATTON
Suffix:
Gender:M
Credentials:MS LCMHC, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 S MAIN ST STE 2D
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4815
Mailing Address - Country:US
Mailing Address - Phone:603-715-1368
Mailing Address - Fax:
Practice Address - Street 1:28 S MAIN ST STE 2D
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4815
Practice Address - Country:US
Practice Address - Phone:603-715-1368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH542101YA0400X
NH854101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)