Shattuck, Wesley
Shattuck, Wesley is an individual health care provider with primary practice located at 226 Rockingham Rd , Londonderry NH 03053-2107. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Shattuck, Wesley can be contacted via phone (603) 425-2989.Contact Information
Primary practice address
226 Rockingham Rd
Londonderry NH 03053-2107
Phone: (603) 425-2989
Fax: (603) 425-2978
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 157 | New Hampshire |
Profile Details
| NPI number | 1356440648 |
|---|---|
| LBN Legal business name | Shattuck, Wesley |
| Credentials | M.ED., LCMHC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Apr 5th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356440648 | NPPES |
| New Hampshire | Other | 1409478Y0NH01 | BLUE CROSS BLUE SHIELD NH |
| New Hampshire | MEDICAID | 30423041 | BLUE CROSS BLUE SHIELD NH |
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