Provider Demographics
NPI:1275370868
Name:WINDING BROOK COUNSELING, PLLC
Entity type:Organization
Organization Name:WINDING BROOK COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC, LCMHC
Authorized Official - Phone:207-200-6336
Mailing Address - Street 1:1461 HOOKSETT RD STE A9
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1813
Mailing Address - Country:US
Mailing Address - Phone:207-200-6336
Mailing Address - Fax:
Practice Address - Street 1:1461 HOOKSETT RD STE A9
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1813
Practice Address - Country:US
Practice Address - Phone:207-200-6336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3115350Medicaid