| Emthibodeau Msw Licsw Llc | |
|
330 New Durham Rd Alton NH 03809-4923 | |
| (603) 941-4878 | |
| Not Available |
| Full Name | Emthibodeau Msw Licsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 330 New Durham Rd, Alton, New Hampshire |
| Authorized Official Name and Position | Estelle M Thibodeau (OWNER) |
| Authorized Official Contact | 6039414878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emthibodeau Msw Licsw Llc 330 New Durham Rd Alton NH 03809-4923 Ph: (603) 941-4878 | Emthibodeau Msw Licsw Llc 330 New Durham Rd Alton NH 03809-4923 Ph: (603) 941-4878 |
| NPI Number | 1659126001 |
|---|---|
| Provider Enumeration Date | 04/19/2024 |
| Last Update Date | 04/19/2024 |
| Certification Date | 04/19/2024 |
| Medicare PECOS PAC ID | 4284074097 |
|---|---|
| Medicare Enrollment ID | O20240426001995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659126001 | NPI | - | NPPES |
| 1265757470 | Other | NH | ANTHEM BCBS |
| 1750304218 | Other | NH | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Estelle M Thibodeau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750304218 PECOS PAC ID: 3971696774 Enrollment ID: I20070911000044 |
Emthibodeau, Licsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 New Durham Rd, Alton, NH 03809 Phone: 603-941-4878 Fax: 603-941-0410 |