Eastern Light Psychiatry

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EASTERN LIGHT PSYCHIATRY

Doing business as

Eastern Light Psychiatry

Practice address

20 Foundry St FL 2
Concord, NH 03301-5419

Phone

(603) 605-0882

Fax

(603) 696-3217

NPI assigned

Aug 7, 2024

Organization subpart

No

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

Authorized official

Name

Michael Scott Jr., APRNNPI 1063058931

Title

Practice Owner

Phone

(208) 313-9590

Specialties & licenses 5

Addresses

Other names 1

• Eastern Light Psychiatry Doing business as

Tax ID family

Eastern Light Psychiatry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eastern Light Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Northwood, NH
  • NPI 1336915495
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Scott, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Manchester, NH
  • NPI 1063058931
  NPD Authorized official

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1194555771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BLAKES HILL RD",
            "city": "NORTHWOOD",
            "state": "NH",
            "postal_code": "032613930",
            "telephone_number": "208-313-9590",
            "fax_number": "603-696-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FOUNDRY ST FL 2",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015419",
            "telephone_number": "603-605-0882",
            "fax_number": "603-696-3217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Tara Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030622809",
            "country_code": "US",
            "telephone_number": "603-605-0882",
            "fax_number": "603-696-3217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Constitution Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106042",
            "country_code": "US",
            "telephone_number": "603-605-0882",
            "fax_number": "603-696-3217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTERN LIGHT PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "208-313-9590",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Light Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Michael Dyson, D.O.
• Janine Nicole Dyson, PA-C
• Virginia Marie Early, MA
• Kellee Jo Easler
• East Point Recovery Centers NH LLC
• Lisa B Eberhart, MSW, LICSW
• Sarah Lee Eberhart, PT,DPT
• Lauren Ebert
• Mary Eckert, MD
• Jonathan J Eddinger, M.D.

• Family Nurse Practitioner in Concord, NH
• Providers in Concord, NH by specialty
• Family Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.