Provider Demographics
NPI:1891125381
Name:STITH, ALEDA G (LCMHC)
Entity Type:Individual
Prefix:
First Name:ALEDA
Middle Name:G
Last Name:STITH
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:ALEDA
Other - Middle Name:GISELLE
Other - Last Name:RICHESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:228 EASTON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:NH
Mailing Address - Zip Code:03580-5405
Mailing Address - Country:US
Mailing Address - Phone:603-616-4025
Mailing Address - Fax:
Practice Address - Street 1:228 EASTON VALLEY RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:NH
Practice Address - Zip Code:03580-5405
Practice Address - Country:US
Practice Address - Phone:603-616-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680085940101YM0800X
NH1125101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1022675Medicaid
NH3102899Medicaid