Provider Demographics
NPI:1639183023
Name:SOARES, FRANK R (MA LMHC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:R
Last Name:SOARES
Suffix:
Gender:M
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:83 WEBSTER AVE
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076
Mailing Address - Country:US
Mailing Address - Phone:603-212-9116
Mailing Address - Fax:
Practice Address - Street 1:857 TURNPIKE ST
Practice Address - Street 2:SUITE 136
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-686-2900
Practice Address - Fax:978-686-2929
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMNC3619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM0722OtherBLUE CROSS BLUE SHIELD