Provider Demographics
NPI:1427714997
Name:WISE MIND COUNSELING, PLLC
Entity type:Organization
Organization Name:WISE MIND COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:O'BRIEN-HART
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-352-0604
Mailing Address - Street 1:20 TRI-CITY ROAD
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-2501
Mailing Address - Country:US
Mailing Address - Phone:603-828-4581
Mailing Address - Fax:603-212-1040
Practice Address - Street 1:90 WASHINGTON ST STE 306
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3744
Practice Address - Country:US
Practice Address - Phone:978-352-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)