Provider Demographics
NPI:1598220410
Name:TJD COUNSELING, INC.
Entity Type:Organization
Organization Name:TJD COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DINSMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-553-2353
Mailing Address - Street 1:4 BIRCH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2136
Mailing Address - Country:US
Mailing Address - Phone:603-553-2353
Mailing Address - Fax:603-552-3129
Practice Address - Street 1:4 BIRCH ST STE 5
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2136
Practice Address - Country:US
Practice Address - Phone:603-553-2353
Practice Address - Fax:603-552-3129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)