| Avery Psychological Services Pa | |
|
27 Bagdad Rd Durham NH 03824-2201 | |
| (603) 868-8100 | |
| (603) 868-1330 |
| Full Name | Avery Psychological Services Pa |
|---|---|
| Speciality | Psychologist |
| Location | 27 Bagdad Rd, Durham, New Hampshire |
| Authorized Official Name and Position | Anne Converse Avery (PRESIDENT/OWNER) |
| Authorized Official Contact | 6038688100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avery Psychological Services Pa 27 Bagdad Rd Durham NH 03824-2201 Ph: (603) 868-8100 | Avery Psychological Services Pa 27 Bagdad Rd Durham NH 03824-2201 Ph: (603) 868-8100 |
| NPI Number | 1417367426 |
|---|---|
| Provider Enumeration Date | 04/29/2014 |
| Last Update Date | 01/12/2015 |
| Medicare PECOS PAC ID | 1052634789 |
|---|---|
| Medicare Enrollment ID | O20151008000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417367426 | NPI | - | NPPES |
| 30010879 | Medicaid | MA | |
| 30424491 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 702 (New Hampshire) | Primary |
| Provider Name | Anne C Avery |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578560603 PECOS PAC ID: 3678463312 Enrollment ID: I20040317000772 |
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