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2 Wellman Ave Ste 215 Nashua NH 03064-1466 | |
| (603) 943-7679 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2 Wellman Ave Ste 215, Nashua, New Hampshire |
| Authorized Official Name and Position | Donna B Lennon (OWNER) |
| Authorized Official Contact | 6039437679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2 Wellman Ave Ste 215 Nashua NH 03064-1466 Ph: (603) 943-7679 | 2 Wellman Ave Ste 215 Nashua NH 03064-1466 Ph: (603) 943-7679 |
| NPI Number | 1861995250 |
|---|---|
| Provider Enumeration Date | 03/13/2018 |
| Last Update Date | 09/05/2024 |
| Certification Date | 09/05/2024 |
| Medicare PECOS PAC ID | 4183150626 |
|---|---|
| Medicare Enrollment ID | O20241209000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861995250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Donna B Lennon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366631517 PECOS PAC ID: 0446603609 Enrollment ID: I20240124003288 |
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