1649583758 NPI number — CELINE JALBERT COMPASS COUNSELING,LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649583758 NPI number — CELINE JALBERT COMPASS COUNSELING,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CELINE JALBERT COMPASS COUNSELING,LLC
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:
Provider Other Organization Name Type Code:
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:
1649583758
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 NORTHEASTERN BLVD
Provider Second Line Business Mailing Address:
UNIT 240A
Provider Business Mailing Address City Name:
NASHUA
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03062-3139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-816-1660
Provider Business Mailing Address Fax Number:
603-816-1661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11 NORTHEASTERN BLVD
Provider Second Line Business Practice Location Address:
UNIT 240A
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03062-3139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-816-1660
Provider Business Practice Location Address Fax Number:
603-816-1661
Provider Enumeration Date:
07/17/2010

Additional Information

Authorized Official

Authorized Official Last Name:
JALBERT
Authorized Official First Name:
CELINE
Authorized Official Middle Name:
PROVENCHER
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
603-867-2757

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  0852 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 762 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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