Provider Demographics
NPI:1922765460
Name:EAST OF THE SEA COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:EAST OF THE SEA COUNSELING SERVICES LLC
Other - Org Name:EAST OF THE SEA COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-237-1812
Mailing Address - Street 1:PO BOX 10682
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-0682
Mailing Address - Country:US
Mailing Address - Phone:603-237-1812
Mailing Address - Fax:696-034-0377
Practice Address - Street 1:753 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-3011
Practice Address - Country:US
Practice Address - Phone:603-237-1812
Practice Address - Fax:603-403-7795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3131564Medicaid