Provider Demographics
NPI:1952404154
Name:LANSFORD, KIMBERLY GAIL (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:GAIL
Last Name:LANSFORD
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:GAIL
Other - Last Name:NEUMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHC
Mailing Address - Street 1:154 BROAD ST
Mailing Address - Street 2:SUITE 1535
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-3205
Mailing Address - Country:US
Mailing Address - Phone:603-546-0297
Mailing Address - Fax:603-546-0292
Practice Address - Street 1:154 BROAD ST
Practice Address - Street 2:SUITE 1535
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-3205
Practice Address - Country:US
Practice Address - Phone:603-546-0297
Practice Address - Fax:603-546-0292
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH304101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30421670Medicaid
NH1409707Y0NH02OtherBHN PROVIDER #