Provider Demographics
NPI:1831617125
Name:GAY, CAROL LYN (MA, LCMHC, MLADC)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:LYN
Last Name:GAY
Suffix:
Gender:F
Credentials:MA, LCMHC, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 TENNEY RD
Mailing Address - Street 2:
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-3104
Mailing Address - Country:US
Mailing Address - Phone:603-953-3069
Mailing Address - Fax:
Practice Address - Street 1:250 COMMERCIAL ST STE 3004
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1118
Practice Address - Country:US
Practice Address - Phone:603-668-3050
Practice Address - Fax:603-668-8666
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1037101YA0400X
NH801101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)