Provider Demographics
NPI:1134838287
Name:EILEEN ROSS, EDM, LCMHC, LLC
Entity type:Organization
Organization Name:EILEEN ROSS, EDM, LCMHC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:EDM
Authorized Official - Phone:603-483-5105
Mailing Address - Street 1:132 PATTEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:CANDIA
Mailing Address - State:NH
Mailing Address - Zip Code:03034-2543
Mailing Address - Country:US
Mailing Address - Phone:603-483-5105
Mailing Address - Fax:603-483-0855
Practice Address - Street 1:132 PATTEN HILL RD
Practice Address - Street 2:
Practice Address - City:CANDIA
Practice Address - State:NH
Practice Address - Zip Code:03034-2543
Practice Address - Country:US
Practice Address - Phone:603-483-5105
Practice Address - Fax:603-483-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)