| Bison Counseling Pllc | |
|
765 S Main St Ste 104 Manchester NH 03102-5141 | |
| (603) 696-6314 | |
| (603) 825-7712 |
| Full Name | Bison Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 765 S Main St Ste 104, Manchester, New Hampshire |
| Authorized Official Name and Position | Melissa Fitzpatrick (OWNER) |
| Authorized Official Contact | 6036966314 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bison Counseling Pllc 765 S Main St Ste 104 Manchester NH 03102-5141 Ph: (603) 696-6314 | Bison Counseling Pllc 765 S Main St Ste 104 Manchester NH 03102-5141 Ph: (603) 696-6314 |
| NPI Number | 1316685662 |
|---|---|
| Provider Enumeration Date | 05/26/2022 |
| Last Update Date | 03/10/2023 |
| Certification Date | 03/10/2023 |
| Medicare PECOS PAC ID | 2365816204 |
|---|---|
| Medicare Enrollment ID | O20230316002518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316685662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Melissa Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134385586 PECOS PAC ID: 5395966865 Enrollment ID: I20141027000530 |
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