Provider Demographics
NPI:1700611902
Name:PRACTICAL PSYCHOTHERAPY INC
Entity type:Organization
Organization Name:PRACTICAL PSYCHOTHERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-836-3469
Mailing Address - Street 1:3 EXECUTIVE PARK DR STE 222
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6985
Mailing Address - Country:US
Mailing Address - Phone:603-836-3469
Mailing Address - Fax:
Practice Address - Street 1:3 EXECUTIVE PARK DR STE 222
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6985
Practice Address - Country:US
Practice Address - Phone:603-836-3469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRACTICAL PSYCHOTHERAPY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-06
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7329OtherSTATE SOCIAL WORK LICENSURE
1134303274OtherNPI TYPE 1
11812720OtherCAQH
NH3228OtherSTATE SOCIAL WORK LICENSURE
1346897337OtherNPI TYPE 2