Provider Demographics
NPI:1528452018
Name:BELANGER, DAVID (MLADC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BELANGER
Suffix:
Gender:M
Credentials:MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1642
Mailing Address - Country:US
Mailing Address - Phone:603-448-4872
Mailing Address - Fax:603-448-1829
Practice Address - Street 1:14 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1642
Practice Address - Country:US
Practice Address - Phone:603-448-4872
Practice Address - Fax:603-448-1829
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0948101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)