Provider Demographics
NPI:1982938171
Name:OMERBEGOVIC, AZRA (MS, MLADC, LCMHC)
Entity Type:Individual
Prefix:
First Name:AZRA
Middle Name:
Last Name:OMERBEGOVIC
Suffix:
Gender:F
Credentials:MS, MLADC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62A DALE RD
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1654
Mailing Address - Country:US
Mailing Address - Phone:603-540-4453
Mailing Address - Fax:603-600-6661
Practice Address - Street 1:62A DALE RD
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1654
Practice Address - Country:US
Practice Address - Phone:603-540-4453
Practice Address - Fax:603-600-6661
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0580101YA0400X
NH2081101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)