Provider Demographics
NPI:1942878483
Name:HEART AND MIND PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:HEART AND MIND PSYCHOLOGICAL SERVICES
Other - Org Name:HEART AND MIND PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARI
Authorized Official - Middle Name:
Authorized Official - Last Name:LESSARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-325-5490
Mailing Address - Street 1:60 PURGATORY RD
Mailing Address - Street 2:
Mailing Address - City:MONT VERNON
Mailing Address - State:NH
Mailing Address - Zip Code:03057-1505
Mailing Address - Country:US
Mailing Address - Phone:603-325-5490
Mailing Address - Fax:
Practice Address - Street 1:31 OLD NASHUA RD STE 14
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2829
Practice Address - Country:US
Practice Address - Phone:603-325-5490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1095OtherLICENSE NUMBER