Provider Demographics
NPI:1619736220
Name:ALPENGLOWCOUNSELIN SERVICES
Entity Type:Organization
Organization Name:ALPENGLOWCOUNSELIN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-986-7211
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-0561
Mailing Address - Country:US
Mailing Address - Phone:603-986-7211
Mailing Address - Fax:
Practice Address - Street 1:21 FERNALD HILLS WAY
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:ME
Practice Address - Zip Code:04037-3257
Practice Address - Country:US
Practice Address - Phone:603-986-7211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty