Provider Demographics
NPI:1497305114
Name:JABLONSKI, LIANE ELISABETH (LCMHC)
Entity Type:Individual
Prefix:
First Name:LIANE
Middle Name:ELISABETH
Last Name:JABLONSKI
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 1:147 THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:RINDGE
Mailing Address - State:NH
Mailing Address - Zip Code:03461-5488
Mailing Address - Country:US
Mailing Address - Phone:603-899-6123
Mailing Address - Fax:
Practice Address - Street 1:147 THOMAS RD
Practice Address - Street 2:
Practice Address - City:RINDGE
Practice Address - State:NH
Practice Address - Zip Code:03461-5488
Practice Address - Country:US
Practice Address - Phone:603-899-6123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-14
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health