Provider Demographics
NPI:1205134855
Name:POLICHRONOPOULOS, MARIE (MA, LCMHC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:POLICHRONOPOULOS
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 COUNTRY CLUB RD UNIT 926
Mailing Address - Street 2:
Mailing Address - City:GILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03249-6978
Mailing Address - Country:US
Mailing Address - Phone:603-493-5758
Mailing Address - Fax:603-589-4977
Practice Address - Street 1:36 COUNTRY CLUB RD UNIT 926
Practice Address - Street 2:
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6978
Practice Address - Country:US
Practice Address - Phone:603-493-5758
Practice Address - Fax:603-589-4977
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health