Provider Demographics
NPI:1831915602
Name:LITTLE BAY COUNSELING, PLLC
Entity type:Organization
Organization Name:LITTLE BAY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-207-2197
Mailing Address - Street 1:LITTLE BAY COUNSELING, PLLC
Mailing Address - Street 2:609 PORTSMOUTH AVE. # 304
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840
Mailing Address - Country:US
Mailing Address - Phone:603-207-2197
Mailing Address - Fax:
Practice Address - Street 1:835 CENTRAL AV., SUITE 126
Practice Address - Street 2:609 PORTSMOUTH AVE. # 304
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820
Practice Address - Country:US
Practice Address - Phone:603-207-2197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty