Provider Demographics
NPI:1538431010
Name:GRETCHEN L. ESTES, MED, LCMHC, PLLC
Entity type:Organization
Organization Name:GRETCHEN L. ESTES, MED, LCMHC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:LITTLEFIELD
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LCMHC
Authorized Official - Phone:603-828-6554
Mailing Address - Street 1:230 COMMERCE WAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-3274
Mailing Address - Country:US
Mailing Address - Phone:603-828-6554
Mailing Address - Fax:603-766-5322
Practice Address - Street 1:230 COMMERCE WAY
Practice Address - Street 2:SUITE 300
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3274
Practice Address - Country:US
Practice Address - Phone:603-828-6554
Practice Address - Fax:877-845-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-31
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty