Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | 435 | NH |
N | 101YP2500X | Professional Counselor | ||
N | 103G00000X | Clinical Psychologist | ||
N | 103TC0700X | Clinical Psychologist | ||
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TS0200X | School Psychologist | 79885 | NH |
NPI | 1497847156 |
---|---|
Provider Name | Dr. Cynthia A. Keenan |
First Address | Portsmouth, NH 03801-3756 |
Second Address | Portsmouth, NH 03801-3756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 04/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11626483 | CAQH PROVIDER ID (01) | NH |