Provider Demographics
NPI:1679627871
Name:PHELPS, NANCY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:A
Last Name:PHELPS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:35 NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-5413
Mailing Address - Country:US
Mailing Address - Phone:802-886-4500
Mailing Address - Fax:802-886-4520
Practice Address - Street 1:390 RIVER ST
Practice Address - Street 2:HCRS
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2226
Practice Address - Country:US
Practice Address - Phone:802-886-4500
Practice Address - Fax:802-886-4520
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048.0050088103TC0700X
NH493103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH064010133NH01OtherBCBS
NH80001970Medicaid
NH2268886OtherCIGNA