Active NPI
Roger Beaudoin, LICSW
- Social Worker
- Goffstown, NH
National Provider Identifier
1598894990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 365
- Practice address
- 279 Shirley Hill Rd
Goffstown, NH 03045-2344 - Phone
- (603) 497-2832
- NPI assigned
- Mar 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 365 | NH | Primary |
Addresses
Primary practice location
279 Shirley Hill Rd
Goffstown, NH 03045-2344
Mailing address
279 Shirley Hill Rd
Goffstown, NH 03045-2344
Phone (603) 497-2832
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8001933 | Medicaid | NH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 365 | NH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Guidance Center of Milford | Social Worker | Past | Accepting new patients |
| Family Guidance Center, PLLC | Social Worker | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Social Worker
- Milford, NH
- NPI 1699929463
-
- Social Worker
- Milford, NH
- NPI 1538974092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598894990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "279 SHIRLEY HILL RD",
"city": "GOFFSTOWN",
"state": "NH",
"postal_code": "030452344",
"telephone_number": "603-497-2832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 SHIRLEY HILL RD",
"city": "GOFFSTOWN",
"state": "NH",
"postal_code": "030452344",
"telephone_number": "603-497-2832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUDOIN",
"first_name": "ROGER",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NH",
"license": "365",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8001933",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goffstown, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.