Jean Fortier, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

409 Issued in NH

Practice address

401 Cypress St
Manchester, NH 03103-3628

Phone

(603) 668-4111

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

Mental Health Counselor

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Mental Health Center of Greater ManchesterGroup PAC ID 6709874274, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Mental Health Center of Greater Manchester

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manchester, NH
  • NPI 1609848811
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1407943129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CYPRESS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033628",
            "telephone_number": "603-668-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CYPRESS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033628",
            "telephone_number": "603-668-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIER",
        "first_name": "JEAN",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "14Y001168NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2072108",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "020258994-37",
            "state": "NH"
        }
    ],
    "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": []
}

• Forge Medical Group, LLC
• Michelle Denise Forgione
• Andrew I. Forrest, MD
• Sara Mae Forrest, BA
• Emily Kathleen Forthofer, OTD, OTR/L
• Daniel Fortin
• Donna Fortin, PHARMD
• Hannah Mountaha Fortin, MSN, APRN, ACNPC-AG
• Kimberly Ann Fortin, CRSW
• Gary Fortune

• Mental Health Counselor in Manchester, NH
• Providers in Manchester, NH by specialty
• Mental Health Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.