| Center For Life Management | |
|
10 Tsienneto Rd Derry NH 03038 | |
| (603) 434-1577 | |
| (603) 434-3101 |
| Full Name | Center For Life Management |
|---|---|
| Speciality | Clinic/Center |
| Location | 10 Tsienneto Rd, Derry, New Hampshire |
| Authorized Official Name and Position | Vic Topo (PRESIDENT & CEO) |
| Authorized Official Contact | 6039650722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Life Management 10 Tsienneto Rd Derry NH 03038 Ph: (603) 434-1577 | Center For Life Management 10 Tsienneto Rd Derry NH 03038 Ph: (603) 434-1577 |
| NPI Number | 1003914466 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 05/13/2015 |
| Medicare PECOS PAC ID | 4981594199 |
|---|---|
| Medicare Enrollment ID | O20040319000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003914466 | NPI | - | NPPES |
| 81263577 | Medicaid | NH |
| Provider Name | Emily Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073699161 PECOS PAC ID: 3870580384 Enrollment ID: I20040427001382 |
| Provider Name | Marcia J Pabo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427076876 PECOS PAC ID: 7113904301 Enrollment ID: I20040706000934 |
| Provider Name | Susan J Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336192343 PECOS PAC ID: 6507817426 Enrollment ID: I20050208000375 |
| Provider Name | Lisa M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396799169 PECOS PAC ID: 7911930896 Enrollment ID: I20050912000923 |
| Provider Name | Kenneth M Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497798557 PECOS PAC ID: 2365464823 Enrollment ID: I20051227000339 |
| Provider Name | Celia Felsenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669550877 PECOS PAC ID: 8729000930 Enrollment ID: I20051230000332 |
| Provider Name | Michelle Simone Saidel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528068517 PECOS PAC ID: 7911913132 Enrollment ID: I20060227000010 |
| Provider Name | Carol A Drouin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033208376 PECOS PAC ID: 0941207930 Enrollment ID: I20061106000178 |
| Provider Name | Walter M Wingate |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083792030 PECOS PAC ID: 5890896518 Enrollment ID: I20070725000548 |
| Provider Name | Karen B Foulke |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1821286949 PECOS PAC ID: 4183536824 Enrollment ID: I20110706000198 |
| Provider Name | Elise Boudreau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104901149 PECOS PAC ID: 1456518059 Enrollment ID: I20120209000662 |
| Provider Name | Isabel K Norian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831205863 PECOS PAC ID: 3072511146 Enrollment ID: I20131007001331 |
| Provider Name | Christina Baldiga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427306877 PECOS PAC ID: 5890926398 Enrollment ID: I20140519000014 |
| Provider Name | Susan M Cater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902147325 PECOS PAC ID: 1658593264 Enrollment ID: I20141117000169 |
| Provider Name | Jillian Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609272764 PECOS PAC ID: 7719208107 Enrollment ID: I20150611000099 |
| Provider Name | Sonya Gelinas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164811188 PECOS PAC ID: 0749592079 Enrollment ID: I20150630000298 |
| Provider Name | Julie Lago |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467857383 PECOS PAC ID: 4284946328 Enrollment ID: I20150702001516 |
| Provider Name | Cynthia A Ebelacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871697342 PECOS PAC ID: 7810030004 Enrollment ID: I20150826000933 |
| Provider Name | Lori Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720331846 PECOS PAC ID: 3173748977 Enrollment ID: I20151118002869 |
| Provider Name | Geraldine Delisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669865473 PECOS PAC ID: 3577509553 Enrollment ID: I20160202000280 |
| Provider Name | Felicia Uzuyem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811367253 PECOS PAC ID: 5193029080 Enrollment ID: I20160215000298 |
| Provider Name | Maryanne F Fournier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629381579 PECOS PAC ID: 5395985956 Enrollment ID: I20160325000218 |
| Provider Name | Elizabeth A Brenden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003938267 PECOS PAC ID: 6709031545 Enrollment ID: I20170419001832 |
| Provider Name | Parisa R Rahimi-britton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811384894 PECOS PAC ID: 3971803271 Enrollment ID: I20180323000074 |
| Provider Name | Susan M Stott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114403565 PECOS PAC ID: 9335498112 Enrollment ID: I20180828002051 |
| Provider Name | Alex Reardon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023675824 PECOS PAC ID: 2264864008 Enrollment ID: I20191115000577 |
| Provider Name | Gerianne Patti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417436734 PECOS PAC ID: 7214347277 Enrollment ID: I20201102001871 |
| Provider Name | Adam Thomas Gilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518493634 PECOS PAC ID: 0648691360 Enrollment ID: I20201120000972 |
| Provider Name | Krysta Marinelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659825503 PECOS PAC ID: 7911312988 Enrollment ID: I20210225000941 |
| Provider Name | Dawn Grist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720660129 PECOS PAC ID: 9032518253 Enrollment ID: I20210520001214 |
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