Provider Demographics
NPI:1710529037
Name:CAPITAL VALLEY COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CAPITAL VALLEY COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:SOBELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-228-7300
Mailing Address - Street 1:8 CENTRE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-6302
Mailing Address - Country:US
Mailing Address - Phone:603-288-7300
Mailing Address - Fax:603-228-7301
Practice Address - Street 1:8 CENTRE ST STE 2
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-6302
Practice Address - Country:US
Practice Address - Phone:603-288-7300
Practice Address - Fax:603-228-7301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:020474816
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30426597Medicaid
NH1403519Y0NH02OtherANTHEM BLUE CROSS BLUE SHIELD
1036802OtherCIGNA