1578772406 NPI number — MS. FRANCES ELLEN NUTTER-UPHAM MA,ATR-BC,LCMHC

Table of content: MS. FRANCES ELLEN NUTTER-UPHAM MA,ATR-BC,LCMHC (NPI 1578772406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578772406 NPI number — MS. FRANCES ELLEN NUTTER-UPHAM MA,ATR-BC,LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NUTTER-UPHAM
Provider First Name:
FRANCES
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA,ATR-BC,LCMHC
Provider Gender Code:
F

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:
1578772406
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 FULTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHUA
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03060-6409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-889-8806
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
174 MAIN ST STE 16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03060-2704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-889-8200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  586 , 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: 04-190 . This is a "REGISTER ART THERAPIST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30423586 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 586 . This is a "LCMHC" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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