Provider Demographics
NPI:1467593020
Name:PARSONS, ANDREA MARTIN (MED, LCMHC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARTIN
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MED, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 FOX POINT RD
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03801-2717
Mailing Address - Country:US
Mailing Address - Phone:603-436-4370
Mailing Address - Fax:603-436-4377
Practice Address - Street 1:156 FOX POINT RD
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-2717
Practice Address - Country:US
Practice Address - Phone:603-436-4370
Practice Address - Fax:603-436-4377
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009137Medicaid