Provider Demographics
NPI:1619481405
Name:FAMILY CENTERED COUNSELING OF NEW ENGLAND, PLLC
Entity Type:Organization
Organization Name:FAMILY CENTERED COUNSELING OF NEW ENGLAND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANDOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:603-809-1534
Mailing Address - Street 1:589 W HOLLIS ST STE 203
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1310
Mailing Address - Country:US
Mailing Address - Phone:603-809-1534
Mailing Address - Fax:
Practice Address - Street 1:589 W HOLLIS ST STE 203
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1310
Practice Address - Country:US
Practice Address - Phone:603-809-1534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty