Provider Demographics
NPI:1326310616
Name:CHRISTINE M POWERS, LICSW, P.L.L.C.
Entity Type:Organization
Organization Name:CHRISTINE M POWERS, LICSW, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-264-6926
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:HENNIKER
Mailing Address - State:NH
Mailing Address - Zip Code:03242-0529
Mailing Address - Country:US
Mailing Address - Phone:603-264-6926
Mailing Address - Fax:603-428-7500
Practice Address - Street 1:41 LIBERTY HILL RD BLDG 2
Practice Address - Street 2:
Practice Address - City:HENNIKER
Practice Address - State:NH
Practice Address - Zip Code:03242-6045
Practice Address - Country:US
Practice Address - Phone:603-264-6926
Practice Address - Fax:603-428-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30429229Medicaid