Change With More Ease LLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Lebanon, NH

NPI 1831865153 · NPPES record last updated Aug 17, 2021

Key facts

NPI
1831865153
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
CHANGE WITH MORE EASE LLC
Practice address
20 W Park St Ste 420
Lebanon, NH 03766-1322
Phone
(603) 667-6743
Fax
(866) 309-2937
NPI assigned
Aug 17, 2021
Organization subpart
No

Authorized official

Name
Mary Ford, PMHNP
Title
Nurse Practitioner
Phone
(603) 667-6743

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20211005001122 NH Part B Supplier - Clinic/Group Practice 6901204064 Receives reassigned benefits from 1 practitioner
Practice locations: Lebanon, NH

National Provider Directory

Locations

20 W Park St
Ste 420
Lebanon, NH 03766
Phone (603) 667-6743

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

20 W Park St Ste 420
Lebanon, NH 03766-1322

Mailing address

329 Murray Hill Dr
Montpelier, VT 05602-4216
Phone (603) 667-6743

Other providers in Lebanon, NH

All providers in Lebanon, NH · Psychiatric/Mental Health Nurse Practitioner in New Hampshire

Sources for this page

Verify at the official NPI Registry.