Provider Demographics
NPI:1346391281
Name:ISENBERG, ANN E (PHD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:ISENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4000
Mailing Address - Country:US
Mailing Address - Phone:603-225-2985
Mailing Address - Fax:603-225-6160
Practice Address - Street 1:21 GREEN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4000
Practice Address - Country:US
Practice Address - Phone:603-225-2985
Practice Address - Fax:603-225-6160
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1004103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30422493Medicaid
NH2074080OtherCIGNA
NH1001533Y0NH01OtherANTHEM
NH2074080OtherCIGNA