Provider Demographics
NPI:1932623931
Name:DEBRA GILLIGAN
Entity Type:Organization
Organization Name:DEBRA GILLIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-216-3327
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03070-0163
Mailing Address - Country:US
Mailing Address - Phone:603-721-6332
Mailing Address - Fax:603-836-4389
Practice Address - Street 1:192 JOE ENGLISH RD
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:NH
Practice Address - Zip Code:03070-3820
Practice Address - Country:US
Practice Address - Phone:603-721-6332
Practice Address - Fax:603-836-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078689Medicaid