Provider Demographics
NPI:1477801009
Name:DINSMORE, THOMAS JOHN (MA, LCMHC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOHN
Last Name:DINSMORE
Suffix:
Gender:M
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BIRCH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2136
Mailing Address - Country:US
Mailing Address - Phone:603-553-2353
Mailing Address - Fax:603-552-3129
Practice Address - Street 1:4 BIRCH ST STE 5
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2136
Practice Address - Country:US
Practice Address - Phone:603-553-2353
Practice Address - Fax:603-552-3129
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1076101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health