Lorraine S Mushacke, LICSW
Individual provider Active NPI Clinical Social Worker · Gorham, NH
NPI 1801928437 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801928437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 1261 (NH)
- Practice address
- 115 Main St
Gorham, NH 03581-1627 - Phone
- (603) 466-5059
- Fax
- (603) 466-5059
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1261 | NH | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1261 | NH | Yes |
Addresses
Primary practice location
115 Main St
Gorham, NH 03581-1627
Mailing address
115 Main St
Gorham, NH 03581-1627
Phone (603) 466-5059
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30423882 | Medicaid | NH |
Other providers in Gorham, NH
- Matthew Thomas Marallo
- John McDowell
- Alice McLane
- Milan School District
- Richard Albert Mitchell
- Amy Beth Page
- Paul C Schoenbeck, DMD., PA
- Ahmad Bin Rashid
- Rite Aid of New Hampshire Inc
- Riverside Wellness Center, PLLC
All providers in Gorham, NH · Clinical Social Worker in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.