Individual provider Active NPI

Herbert Samuel Demmin, PH.D.

  • Clinical Psychologist
  • Nashua, NH
National Provider Identifier
1912062167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
NH-580 Issued in NH
Practice address
65 Technology Way
Suite 3W7
Nashua, NH 03060-3245
Phone
(603) 886-5565
Fax
(603) 886-8642
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NH-580 NH Primary

Addresses

Primary practice location

65 Technology Way
Suite 3W7
Nashua, NH 03060-3245

Mailing address

65 Technology Way
Suite 3W7
Nashua, NH 03060-3245
Phone (603) 886-5565

Other identifiers 1

IdentifierTypeStateIssuer
30420967MedicaidNH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051104000146 NH Practitioner - Clinical Psychologist 9335167782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

65 Technology Way
Nashua, NH 03060-3245
Phone (603) 886-5565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
NH-580NHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New England Center for Comprehensive Counseling Services Clinical CurrentSince Apr 8, 1991 Accepting new patients

Locations

65 Technology Way
Nashua, NH 03060
Phone (603) 886-5565

4 Bud Way
Ste 9
Nashua, NH 03063
Phone (603) 886-5565

65 Technology Way
#3W7
Nashua, NH 03060

65 Technology Way
Ste 3W7
Nashua, NH 03060
Phone (603) 886-5565

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912062167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 TECHNOLOGY WAY",
            "address_2": "SUITE 3W7",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603245",
            "telephone_number": "603-886-5565",
            "fax_number": "603-886-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 TECHNOLOGY WAY",
            "address_2": "SUITE 3W7",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603245",
            "telephone_number": "603-886-5565",
            "fax_number": "603-886-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMMIN",
        "first_name": "HERBERT",
        "middle_name": "SAMUEL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "NH-580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30420967",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.