Provider Demographics
NPI:1326282294
Name:HARKINS, MICHELLE CANTLIN (CMHC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:CANTLIN
Last Name:HARKINS
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-5413
Mailing Address - Country:US
Mailing Address - Phone:603-865-1321
Mailing Address - Fax:603-865-1327
Practice Address - Street 1:2 BUCK RD STE J
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-2715
Practice Address - Country:US
Practice Address - Phone:603-865-1321
Practice Address - Fax:603-865-1327
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1038101YA0400X
NH0135101YA0400X
VT151.0127053101YA0400X
NH1981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE2534Medicare PIN