Provider Demographics
NPI:1578596078
Name:STIMMELL, JEAN L (LCMHC)
Entity Type:Individual
Prefix:MR
First Name:JEAN
Middle Name:L
Last Name:STIMMELL
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 JENNESS POND RD
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03261-3111
Mailing Address - Country:US
Mailing Address - Phone:603-942-5889
Mailing Address - Fax:
Practice Address - Street 1:524 JENNESS POND RD
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:NH
Practice Address - Zip Code:03261-3111
Practice Address - Country:US
Practice Address - Phone:603-942-5889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH255101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH.114339OtherTEAMSTERS BEHAVIORAL HEAL
NH118708OtherBEHAVIORAL HEALTH NETWORK
NH2163827OtherCIGNA BEHAVIORAL HEALTH
NH14Y001621NH01OtherANTHEM BCBS
NH30422461Medicaid