Provider Demographics
NPI:1881244598
Name:BEAUCHEMIN, DAVID JOSEPH
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:BEAUCHEMIN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:JOSEPH
Other - Last Name:BEAUCHEMIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRSW
Mailing Address - Street 1:303 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-4311
Mailing Address - Country:US
Mailing Address - Phone:603-461-4480
Mailing Address - Fax:
Practice Address - Street 1:303 BELMONT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4311
Practice Address - Country:US
Practice Address - Phone:603-263-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-14
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)