Provider Demographics
NPI:1902637754
Name:CHERYL DOUCETTE ANP BC PMHCNS BC LLC
Entity type:Organization
Organization Name:CHERYL DOUCETTE ANP BC PMHCNS BC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOUCETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-728-8872
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:NORTH WOODSTOCK
Mailing Address - State:NH
Mailing Address - Zip Code:03262-0005
Mailing Address - Country:US
Mailing Address - Phone:603-728-8872
Mailing Address - Fax:603-745-7089
Practice Address - Street 1:21 MOUNTAIN PARK DRIVE
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NH
Practice Address - Zip Code:03262-0005
Practice Address - Country:US
Practice Address - Phone:603-728-8872
Practice Address - Fax:603-745-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1316969611OtherPROVIDER NPI