Provider Demographics
NPI:1396878864
Name:AFSHAR, FOAD (PSYD)
Entity type:Individual
Prefix:DR
First Name:FOAD
Middle Name:
Last Name:AFSHAR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FERRY ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5022
Mailing Address - Country:US
Mailing Address - Phone:603-223-5966
Mailing Address - Fax:603-223-5967
Practice Address - Street 1:10 FERRY ST
Practice Address - Street 2:SUITE 307
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5022
Practice Address - Country:US
Practice Address - Phone:603-223-5966
Practice Address - Fax:603-223-5967
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423809Medicaid