Provider Demographics
NPI:1679351365
Name:MERCY INTEGRATED THERAPY SOLUTIONS
Entity Type:Organization
Organization Name:MERCY INTEGRATED THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHC
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CINCEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-722-8382
Mailing Address - Street 1:25 CORNERSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03276-4004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 CANDIA RD UNIT 9
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-5512
Practice Address - Country:US
Practice Address - Phone:603-722-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty