Provider Demographics
NPI:1669577375
Name:RAO, JAMES ALBERT (LMSW, PHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALBERT
Last Name:RAO
Suffix:
Gender:M
Credentials:LMSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-5413
Mailing Address - Country:US
Mailing Address - Phone:603-865-1321
Mailing Address - Fax:603-865-1327
Practice Address - Street 1:2 BUCK RD STE J
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-2715
Practice Address - Country:US
Practice Address - Phone:603-865-1321
Practice Address - Fax:603-865-1327
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH22961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY070571OtherLICENSE #: