Provider Demographics
NPI:1235331208
Name:FULCRUM BEHAVIORAL CONSULTANTS LTD
Entity Type:Organization
Organization Name:FULCRUM BEHAVIORAL CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:COLBY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-528-5968
Mailing Address - Street 1:734 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2777
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:734 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2777
Practice Address - Country:US
Practice Address - Phone:603-528-5968
Practice Address - Fax:603-528-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH736251B00000X, 251E00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251E00000XAgenciesHome Health
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30852367Medicaid
NH52256OtherSTATE OF NEW HAMPSHIRE
NH30852367Medicare ID - Type Unspecified