NPIMap

Organization Active NPI

Wild Irish Farm, LLC

  • Clinical Social Worker
  • Newington, NH
National Provider Identifier
1285915199
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1345 Issued in NH
Legal business name
WILD IRISH FARM, LLC
Practice address
408 Newington Rd
Newington, NH 03801-2730
Phone
(603) 436-2022
NPI assigned
Sep 6, 2011
Last updated
Sep 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Mrs. Laura M Peterson, LICSWNPI 1407008345
Title
Clinician
Phone
(603) 436-2022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 1345 NH Primary

Addresses

Primary practice location

408 Newington Rd
Newington, NH 03801-2730

Mailing address

408 Newington Rd
Newington, NH 03801-2730
Phone (603) 436-2022

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1285915199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 NEWINGTON RD",
            "city": "NEWINGTON",
            "state": "NH",
            "postal_code": "038012730",
            "telephone_number": "603-436-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 NEWINGTON RD",
            "city": "NEWINGTON",
            "state": "NH",
            "postal_code": "038012730",
            "telephone_number": "603-436-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD IRISH FARM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "603-436-2022",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.