Provider Demographics
NPI:1861857559
Name:PIGEON, NICHOLAS (LICSW)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:PIGEON
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:NICHOLAS
Other - Middle Name:
Other - Last Name:PIGEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:3 EXECUTIVE PARK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6954
Mailing Address - Country:US
Mailing Address - Phone:603-440-9013
Mailing Address - Fax:
Practice Address - Street 1:3 EXECUTIVE PARK DR STE 201
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6954
Practice Address - Country:US
Practice Address - Phone:603-440-9013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-22
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist