1629581137 NPI number — LINDA A GUTTMAN PSY D PLLC

Table of content: (NPI 1629581137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629581137 NPI number — LINDA A GUTTMAN PSY D PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINDA A GUTTMAN PSY D PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LINDA A GUTTMAN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629581137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 WOODRIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03824-2917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-969-7680
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03824-2501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-969-7680
Provider Business Practice Location Address Fax Number:
603-969-7680
Provider Enumeration Date:
11/07/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUTTMAN
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
LICENSED PSYCHOLOGIST
Authorized Official Telephone Number:
603-969-7680

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  537 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13673938 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".