Provider Demographics
NPI:1164544029
Name:CODY, ARLENE G (LCMHC)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:G
Last Name:CODY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4127
Mailing Address - Country:US
Mailing Address - Phone:603-889-9431
Mailing Address - Fax:603-880-4643
Practice Address - Street 1:215 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4354
Practice Address - Country:US
Practice Address - Phone:603-668-0014
Practice Address - Fax:603-623-7676
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH5537643OtherUBH
NH14007408NH01OtherBHNBCBS
NH30423066Medicaid
NH11656404OtherCAQH
NH2231208OtherFIRST HEALTH