Provider Demographics
NPI:1801196332
Name:GREATER NASHUA COUNCIL ON ALCOHOLISM, INC.
Entity Type:Organization
Organization Name:GREATER NASHUA COUNCIL ON ALCOHOLISM, INC.
Other - Org Name:CYNTHIA DAY FAMILY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:LIANE
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, MLADC
Authorized Official - Phone:603-881-4848
Mailing Address - Street 1:615 AMHERST STREET
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063
Mailing Address - Country:US
Mailing Address - Phone:603-881-4848
Mailing Address - Fax:603-598-3644
Practice Address - Street 1:615 AMHERST STREET
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063
Practice Address - Country:US
Practice Address - Phone:603-881-4848
Practice Address - Fax:603-598-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
NH101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty