Provider Demographics
NPI:1104486612
Name:TARANOW, MITCHELL (CMHC)
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:
Last Name:TARANOW
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4049
Mailing Address - Country:US
Mailing Address - Phone:603-520-6936
Mailing Address - Fax:603-520-6936
Practice Address - Street 1:33 WARREN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4049
Practice Address - Country:US
Practice Address - Phone:603-520-6936
Practice Address - Fax:603-520-6936
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health