The Lakes Region Mental Health Center, Inc.
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Laconia, NH
NPI 1902994866 · NPPES record last updated Jan 29, 2021
Key facts
- NPI
- 1902994866
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- THE LAKES REGION MENTAL HEALTH CENTER, INC.
- Practice address
- 40 Beacon St E
Laconia, NH 03246-3437 - Phone
- (603) 524-1100
- Fax
- (603) 527-8113
- NPI assigned
- Oct 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Cheryl Ferren
- Title
- Director Revenue Cycle Management
- Phone
- (603) 524-1100
Practitioners 279
-
Dakota Downing, LICSW
-
Marisa Fritchy, LICSW
-
Nancy Gallagher, APRN
-
Kristen Grant, MLADC
-
Jessica Graton, LICSW
-
Nadia Harrigan, APRN
-
Vladimir Jelnov, MD
-
Julia Lanni, APRN
-
Hallick Lehmann, MSN, RN, PMHNP-BC
-
Alison O'Neill, MS, LCMHC
-
Melinda Celina Taylor-Bosworth, PMHNP-BC
-
Kristen Ventola, LICSW
-
Mark W Wagner, MD
-
Christopher Burns, PMHNP
-
Hope Dixon, M.A.
-
Tami Hayhurst, PMHNP, MSN
-
Jessica Kangas, MA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 30D2113863 | Lakes Region Mental Health Center | Certificate of waiver | Jun 1, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050127000134 | NH | Part B Supplier - Clinic/Group Practice | 7911957964 |
Receives reassigned benefits from 28 practitioners Practice locations: Laconia, NH; Plymouth, NH |
National Provider Directory
Locations
771 N Main St
Laconia, NH 03246
Phone 6035241100256
111 Church St
Laconia, NH 03246
Phone (603) 934-1464
81 Highland St
Plymouth, NH 03264
Phone (603) 536-1118
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
40 Beacon St E
Laconia, NH 03246-3437
Mailing address
40 Beacon St E
Laconia, NH 03246-3437
Phone (603) 524-1100
Other practice location 1
81 Highland St
Plymouth, NH 03264-1249
Phone (603) 524-1100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LAKE663566 | Other | NH | ANTHEM |
| 3076838 | Medicaid | NH |
Other names
- Genesis Behavioral Health
Other providers in Laconia, NH
- Richard O. Teed
- Daryll Tenney
- Denise Tennyson
- Michael Tensel
- Laurie Terwilliger
- Sheeba M Thomas
- Christine M. Thompson
- Jerilyn Thurlow
- Jennifer Brown Tichich
- Sarah E Tinkham
All providers in Laconia, NH · Mental Health Clinic/Center (Including Community Mental Health Center) 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 Jan 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.