Provider Demographics
NPI:1194860122
Name:REICHHELD, THOMAS MANFORD (LCMHC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MANFORD
Last Name:REICHHELD
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO FALLS
Mailing Address - State:NH
Mailing Address - Zip Code:03896-0122
Mailing Address - Country:US
Mailing Address - Phone:603-569-5818
Mailing Address - Fax:
Practice Address - Street 1:35 CENTER ST
Practice Address - Street 2:THE OFFICE
Practice Address - City:WOLFEBORO FALLS
Practice Address - State:NH
Practice Address - Zip Code:03896-9998
Practice Address - Country:US
Practice Address - Phone:603-569-5818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008612Medicaid