Provider Demographics
NPI:1487412862
Name:PELLETIER, SHAWNA N (LMHC AND LCMHC)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:N
Last Name:PELLETIER
Suffix:
Gender:F
Credentials:LMHC AND LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 FOX MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4357
Mailing Address - Country:US
Mailing Address - Phone:603-512-1216
Mailing Address - Fax:
Practice Address - Street 1:13 FOX MEADOW RD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4357
Practice Address - Country:US
Practice Address - Phone:035-121-2166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2811101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health