| Carol L Mandigo Licsw Llc | |
|
83 Clinton St Concord NH 03301-2262 | |
| (603) 225-4400 | |
| (603) 226-0070 |
| Full Name | Carol L Mandigo Licsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 83 Clinton St, Concord, New Hampshire |
| Authorized Official Name and Position | Carol Mandigo (OWNER) |
| Authorized Official Contact | 6032254400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol L Mandigo Licsw Llc 83 Clinton St Concord NH 03301-2262 Ph: (603) 225-4400 | Carol L Mandigo Licsw Llc 83 Clinton St Concord NH 03301-2262 Ph: (603) 225-4400 |
| NPI Number | 1760964639 |
|---|---|
| Provider Enumeration Date | 09/06/2018 |
| Last Update Date | 09/10/2018 |
| Medicare PECOS PAC ID | 5698026375 |
|---|---|
| Medicare Enrollment ID | O20180919000891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760964639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | NH372 (New Hampshire) | Primary |
| Provider Name | Carol L Mandigo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164690228 PECOS PAC ID: 6507944279 Enrollment ID: I20080421000461 |
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