Provider Demographics
NPI:1972754430
Name:FAMILY TREE GUIDANCE SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY TREE GUIDANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-479-5282
Mailing Address - Street 1:370 PORTSMOUTH AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2252
Mailing Address - Country:US
Mailing Address - Phone:603-435-3323
Mailing Address - Fax:866-567-6780
Practice Address - Street 1:370 PORTSMOUTH AVE UNIT 207
Practice Address - Street 2:
Practice Address - City:GREENLAND
Practice Address - State:NH
Practice Address - Zip Code:03840-2252
Practice Address - Country:US
Practice Address - Phone:603-435-3323
Practice Address - Fax:866-567-6780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH676101YM0800X
NH12411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty