Provider Demographics
NPI:1548603632
Name:THE BIRCH STREET COUNSELING CTR., INC
Entity Type:Organization
Organization Name:THE BIRCH STREET COUNSELING CTR., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LCMHC
Authorized Official - Phone:603-425-2989
Mailing Address - Street 1:226 ROCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2107
Mailing Address - Country:US
Mailing Address - Phone:603-425-2989
Mailing Address - Fax:603-425-2978
Practice Address - Street 1:226 ROCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-2107
Practice Address - Country:US
Practice Address - Phone:603-425-2989
Practice Address - Fax:603-425-2978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075150Medicaid