Provider Demographics
NPI:1316685662
Name:BISON COUNSELING PLLC
Entity type:Organization
Organization Name:BISON COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:603-696-6314
Mailing Address - Street 1:765 S MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-5141
Mailing Address - Country:US
Mailing Address - Phone:603-696-6314
Mailing Address - Fax:603-825-7712
Practice Address - Street 1:765 S MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-5141
Practice Address - Country:US
Practice Address - Phone:603-696-6314
Practice Address - Fax:603-825-7712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty