Provider Demographics
NPI:1619185329
Name:ALLEN, JEANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-0057
Mailing Address - Country:US
Mailing Address - Phone:603-778-7433
Mailing Address - Fax:603-778-0022
Practice Address - Street 1:24 FRONT ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2727
Practice Address - Country:US
Practice Address - Phone:603-778-7433
Practice Address - Fax:603-778-0022
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30007463Medicaid
NH30007463Medicaid