Provider Demographics
NPI:1861101594
Name:ACCESS MENTAL HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:ACCESS MENTAL HEALTH SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:603-600-1033
Mailing Address - Street 1:1001 ELM ST SUITE 106H
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-5410
Mailing Address - Country:US
Mailing Address - Phone:603-600-1033
Mailing Address - Fax:978-428-5811
Practice Address - Street 1:225 STEDMAN ST STE 14
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2784
Practice Address - Country:US
Practice Address - Phone:603-600-1033
Practice Address - Fax:978-428-5811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESS MENTAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-21
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861101594OtherAETNA
1861101594OtherCIGNA
1861101594OtherBLUE CROSS BLUE SHIELD
1861101594OtherHARVARD PILGRIM
MA1861155426Medicaid