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Organization
DEER CREEK PSYCHOLOGICAL ASSOCIATES, PA
Active
Organization
DEER CREEK PSYCHOLOGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND J. CHIN PHD (PRESIDENT)
(603) 643-9252
Entity
Organization
Contact information
Practice address
45 LYME RD, SUITE 202A, HANOVER, NH 03755-1219
(802) 785-2543
(802) 785-2631
Mailing address
PO BOX 266, EAST THETFORD, VT 05043-0266
(802) 785-2903
(802) 785-2631
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062-19470
VT BLUECROSS BLUESHIELD
VT
01
—
50Y303300VT01
ANTHEM BCBS
NH
Enumeration date
08/17/2006
Last updated
10/21/2014
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