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DEER CREEK PSYCHOLOGICAL ASSOCIATES, PA

Clinical Neuropsychologist

Hanover, New Hampshire

Provider NPI: 1992818439

Organization Information:
Organization Name:  DEER CREEK PSYCHOLOGICAL ASSOCIATES, PA
Organization is not Subpart
Authorized Official:  RAYMOND J. CHIN  PRESIDENT  603-6439252

Practice Location:
45 LYME RD SUITE 202A HANOVER, NH 03755 US
Tel: 802-785-2543  Fax: 802-785-2631

Business Mailing Address:
PO BOX 266  EAST THETFORD, VT 05043 US
Tel: 802-785-2903  Fax: 802-785-2631

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
N103TB0200XBehavioral Health & Social Service Providers
Psychologist
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
Y101YM0800XBehavioral Health & Social Service Providers
Counselor

Other Provider Identifiers:

IssuerNumberStateType
ANTHEM BCBS50Y303300VT01NH01
VT BLUECROSS BLUESHIELD062-19470VT01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS NH - Page 1



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