Provider Demographics
NPI:1801922380
Name:VACHON, PAULINE J (MA LCMHC)
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:J
Last Name:VACHON
Suffix:
Gender:F
Credentials:MA LCMHC
Other - Prefix:
Other - First Name:PAULINE
Other - Middle Name:J
Other - Last Name:GOUPIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LCMHC
Mailing Address - Street 1:128 CURTIS BROOK RD
Mailing Address - Street 2:
Mailing Address - City:LYNDEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03082-6420
Mailing Address - Country:US
Mailing Address - Phone:603-654-9203
Mailing Address - Fax:
Practice Address - Street 1:17 OLD NASHUA RD #4
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2839
Practice Address - Country:US
Practice Address - Phone:603-622-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH147103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist