Provider Demographics
NPI:1437435062
Name:CONNECTICUT RIVER COUNSELING SVCS.
Entity Type:Organization
Organization Name:CONNECTICUT RIVER COUNSELING SVCS.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:O'HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, MLADC, LCS
Authorized Official - Phone:603-747-2801
Mailing Address - Street 1:P.O. BOX 223
Mailing Address - Street 2:139 CENTRAL ST.
Mailing Address - City:WOODSVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03785
Mailing Address - Country:US
Mailing Address - Phone:603-747-2801
Mailing Address - Fax:603-747-2801
Practice Address - Street 1:139 CENTRAL ST.
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785
Practice Address - Country:US
Practice Address - Phone:603-747-2801
Practice Address - Fax:603-747-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty