Provider Demographics
NPI:1487029740
Name:ESCHENBRENNER, LAURI ANN (LCMHC-NH 2179)
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:ANN
Last Name:ESCHENBRENNER
Suffix:
Gender:F
Credentials:LCMHC-NH 2179
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 ROUTE 101 STE 10
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5031
Mailing Address - Country:US
Mailing Address - Phone:603-472-2846
Mailing Address - Fax:
Practice Address - Street 1:360 ROUTE 101 STE 10
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110
Practice Address - Country:US
Practice Address - Phone:603-472-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2179101YM0800X
OHC.1100597101YM0800X
AZLAC15280101YM0800X
NHNH-2179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2179-LCMHCOtherBOARD OF MENTAL HEALTH PRACTICE