Mary Croasdale

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

25 W Main St
Conway, NH 03818-6142

Phone

(603) 447-2111

NPI assigned

Sep 15, 2008

Last updated

Sep 15, 2008By the provider in NPPES

Sex

Female

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 2

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northern Human ServicesGroup PAC ID 3173595931, 27 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Center Conway, NH
  • NPI 1700955028
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1790934719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 WASHINGTON ST",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186044",
            "telephone_number": "603-447-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W MAIN ST",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186142",
            "telephone_number": "603-447-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROASDALE",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "7706638Y0NH01",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81263824",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Conway
• Gloria Ruth Cote, ARNP
• Charles Cotton, LICSW
• Kara Marie Couture
• Robin Joy Crawford
• Deborah Ann Cross, ARNP
• Heather Cunningham
• Alec Daigle, DMD
• Gretchen Davidson, LICSW
• Lorraine Davis, WAIVER

• Counselor in Conway, NH
• Providers in Conway, NH by specialty
• Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.