Individual provider Active NPI

Tara Rousselle, LCMHC, MLADC

  • Mental Health Counselor
  • Manchester, NH
National Provider Identifier
1194057455
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2026 Issued in NH
Practice address
2 Wall St
Manchester, NH 03101-1518
Phone
(603) 668-4111
Fax
(603) 628-7757
NPI assigned
Feb 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 2026 NH Primary

Addresses

Primary practice location

2 Wall St
Manchester, NH 03101-1518

Mailing address

2 Wall St Ste 200
Manchester, NH 03101-1518
Phone (603) 668-4111

Other names 1

  • Tara Rousselle Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115001032 NH Practitioner - Mental Health Counselor 1355793415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Mental Health Center of Greater ManchesterGroup PAC ID 6709874274, 86 clinicians

Practice addresses (Care Compare)

2 Wall St
Manchester, NH 03101-1518
Phone (603) 668-4111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2026NHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Mental Health Center of Greater Manchester CurrentSince Jan 1, 2024 Accepting new patients

Locations

2 Wall St
Ste 200
Manchester, NH 03101

2 Wall St
Ste 300
Manchester, NH 03101
Phone (603) 668-1111

2 Wall St
Manchester, NH 03101
Phone 6036684111 ext. 6900

401 Cypress St
Manchester, NH 03103
Phone (603) 206-8586

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1194057455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 200",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WALL ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSELLE",
        "first_name": "TARA",
        "credential": "LCMHC, MLADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-10",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "2026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "401 Cypress St",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031033628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "ROUSSELLE",
            "credential": "MA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.