Provider Demographics
NPI:1639314842
Name:ZACAROLI, GRACE L (LCHMC)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:L
Last Name:ZACAROLI
Suffix:
Gender:F
Credentials:LCHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 HOOKSETT RD UNIT 1371
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1892
Mailing Address - Country:US
Mailing Address - Phone:603-315-2862
Mailing Address - Fax:
Practice Address - Street 1:123 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4200
Practice Address - Country:US
Practice Address - Phone:406-247-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1368101YP2500X
NH860101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional