Provider Demographics
NPI:1831373174
Name:VIANA, JOSEPH M (CRC, LCPC, LCMHC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:M
Last Name:VIANA
Suffix:
Gender:M
Credentials:CRC, LCPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RABBIT RUN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NH
Mailing Address - Zip Code:03849-5743
Mailing Address - Country:US
Mailing Address - Phone:603-367-8418
Mailing Address - Fax:
Practice Address - Street 1:448 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:TAMWORTH
Practice Address - State:NH
Practice Address - Zip Code:03886-4626
Practice Address - Country:US
Practice Address - Phone:603-539-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH639101YM0800X
MECC2364101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional