Individual provider Active NPI

Desmond Stern, MS, LCMHC

  • Mental Health Counselor
  • Concord, NH
National Provider Identifier
1558870592
Registry record updated Feb 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2322 Issued in NH
Practice address
75 S. Main St
PMB 335
Concord, NH 03301
Phone
(301) 202-4495
NPI assigned
Sep 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2322 NH Primary

Addresses

Primary practice location

75 S. Main St
PMB 335
Concord, NH 03301

Mailing address

75 S. Main St
PMB 335
Concord, NH 03301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 21, 2024 through Feb 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2322NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hazel Tree Wellness, LLC Mental Health CurrentSince Feb 25, 2024 Accepting new patients
Riverbend Community Mental Health, Inc. PastSince Jul 10, 2012 Accepting new patients
Riverbend Community Mental Health, Inc. PastSince Aug 26, 2023 Accepting new patients

Locations

75 S Main St
Concord, NH 03301
Phone (301) 202-4495

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708214400000",
    "number": "1558870592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 S. MAIN ST",
            "address_2": "PMB 335",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "03301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S. MAIN ST",
            "address_2": "PMB 335",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "03301",
            "telephone_number": "301-202-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "DESMOND",
        "credential": "MS, LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2024-02-18",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "2322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.