Provider Demographics
NPI:1659917052
Name:TORGERSEN, GUY LOYD (LADC)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:LOYD
Last Name:TORGERSEN
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1635
Mailing Address - Country:US
Mailing Address - Phone:603-809-9007
Mailing Address - Fax:603-626-5811
Practice Address - Street 1:50 LOWELL ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1635
Practice Address - Country:US
Practice Address - Phone:603-809-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1207101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH165-9917052Medicaid