Provider Demographics
| NPI: | 1144275389 |
|---|---|
| Name: | THE COUNSELING CENTER OF NASHUA INC |
| Entity type: | Organization |
| Organization Name: | THE COUNSELING CENTER OF NASHUA INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF LEGAL OFFICER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | RYAN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | PARDO |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 425-279-8500 |
| Mailing Address - Street 1: | 1 MAIN ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | NASHUA |
| Mailing Address - State: | NH |
| Mailing Address - Zip Code: | 03064-2716 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 603-883-0005 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1 MAIN ST |
| Practice Address - Street 2: | |
| Practice Address - City: | NASHUA |
| Practice Address - State: | NH |
| Practice Address - Zip Code: | 03064 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 603-883-0005 |
| Practice Address - Fax: | 603-883-0007 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-05-24 |
| Last Update Date: | 2023-10-23 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 103G00000X | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | Group - Multi-Specialty | |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
| No | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging | Group - Multi-Specialty |
| No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling | Group - Multi-Specialty |
| No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
| No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
| No | 103TF0200X | Behavioral Health & Social Service Providers | Psychologist | Forensic | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NH | 80003475 | Medicaid | |
| RE3475 | Medicare ID - Type Unspecified |
