Individual
JENNIFER CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, MLADC
Contact information
Practice address
464 CHESTNUT ST, MANCHESTER, NH 03101-1804
(603) 518-4325
(603) 668-6260
Mailing address
464 CHESTNUT ST, MANCHESTER, NH 03101-1804
(603) 518-4325
(603) 668-6260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0887
NH
1041C0700X
Clinical Social Worker
Primary
1788
NH
Other
Enumeration date
12/04/2012
Last updated
07/03/2014
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