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Organization
GRANITE STATE COUNSELING AND ASSESSMENT, P.L.L.C.
Active
Organization
GRANITE STATE COUNSELING AND ASSESSMENT, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN M LONG LCMHC (PRINCIPAL)
(207) 292-2546
Entity
Organization
Contact information
Practice address
466 CENTRAL AVE STE 8, DOVER, NH 03820-6418
(207) 292-2546
Mailing address
466 CENTRAL AVE STE 8, DOVER, NH 03820-6418
(207) 292-2546
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103G00000X
Clinical Neuropsychologist
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023286390
—
NH
Enumeration date
04/05/2023
Last updated
04/05/2023
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