Active NPI
Kimberly Ann Fortin, CRSW
- Addiction (Substance Use Disorder) Counselor
- Manchester, NH
National Provider Identifier
1326871690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 0327
- Practice address
- 1 Elliot Way
Manchester, NH 03103-3599 - Phone
- (603) 663-4430
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0327 | NH | Primary |
Addresses
Primary practice location
1 Elliot Way
Manchester, NH 03103-3599
Mailing address
1 Elliot Way
Manchester, NH 03103-3599
Phone (603) 663-4430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0327 | NH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1326871690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ELLIOT WAY",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031033599",
"telephone_number": "603-663-4430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ELLIOT WAY",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031033599",
"telephone_number": "603-663-4430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTIN",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "CRSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2025-01-07",
"certification_date": "2025-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NH",
"license": "0327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.