Provider Demographics
NPI:1659897510
Name:CANEY, KRYSTAL N (LCMHC)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:N
Last Name:CANEY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GAGE ST
Mailing Address - Street 2:
Mailing Address - City:BOSCAWEN
Mailing Address - State:NH
Mailing Address - Zip Code:03303-1315
Mailing Address - Country:US
Mailing Address - Phone:603-236-1621
Mailing Address - Fax:
Practice Address - Street 1:70 COMMERCIAL ST STE 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5094
Practice Address - Country:US
Practice Address - Phone:603-689-7890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2408101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health