Provider Demographics
NPI:1720164007
Name:SMITH, PAUL G (LCMHC, MA)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:G
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCMHC, MA
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:G
Other - Last Name:FOSTER-SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:199 BEAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHICHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03258-6205
Mailing Address - Country:US
Mailing Address - Phone:603-470-9388
Mailing Address - Fax:
Practice Address - Street 1:2 UNION ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4249
Practice Address - Country:US
Practice Address - Phone:603-226-6609
Practice Address - Fax:603-226-6609
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30420275Medicaid
NH286OtherLICENSE NUMBER