Provider Demographics
NPI:1326580382
Name:ANASTACIO, APRYL RAE (LCMHC)
Entity Type:Individual
Prefix:
First Name:APRYL
Middle Name:RAE
Last Name:ANASTACIO
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 1:312 OLD NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-4359
Mailing Address - Country:US
Mailing Address - Phone:508-789-0922
Mailing Address - Fax:508-342-7145
Practice Address - Street 1:312 OLD NEWPORT RD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-4359
Practice Address - Country:US
Practice Address - Phone:603-504-5795
Practice Address - Fax:508-342-7145
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2483101YM0800X
MA11694-MH-CC101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1326580382Medicaid