Lindsay Prudhomme, MSW, LICSW

Individual provider Active NPI Clinical Social Worker · Pelham, NH

NPI 1306236047 · NPPES record last updated Sep 25, 2023

Key facts

NPI
1306236047
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2249 (NH)
Practice address
17 Windham Rd FL 2
Pelham, NH 03076-2371
Phone
(603) 321-4086
NPI assigned
Feb 3, 2015
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
221727MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bodhi Counseling Services LLC Past
since Sep 5, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 221727 MA
Clinical Social Worker 1041C0700X 2249 NH Yes

Addresses

Primary practice location

17 Windham Rd FL 2
Pelham, NH 03076-2371

Mailing address

17 Windham Rd FL 2
Pelham, NH 03076-2371
Phone (603) 321-4086

Other identifiers

IdentifierTypeStateIssuer
3119186MedicaidNH

Other providers in Pelham, NH

All providers in Pelham, NH · Clinical Social Worker in New Hampshire

Sources for this page

Verify at the official NPI Registry.