Provider Demographics
NPI:1821163247
Name:BOIS, JENNIFER A (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:BOIS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 BROAD ST STE 1511
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-3205
Mailing Address - Country:US
Mailing Address - Phone:603-577-5551
Mailing Address - Fax:603-577-5576
Practice Address - Street 1:154 BROAD ST STE 1511
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-3205
Practice Address - Country:US
Practice Address - Phone:603-577-5551
Practice Address - Fax:603-577-5576
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH665101YA0400X
NH629101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH632972OtherVALUE OPTIONS
NH14Y010795NH02OtherANTHEM
NHJ BOIS SLATTERYOtherTEAMSTERSCARE
NH30424736Medicaid
NH207788553-01OtherUNITED BEHAVIORAL HEALTH/HARVARD PILGRIM
NH2563251OtherCIGNA BEHAVIORAL HEALTH