Organization
EASTERN LIGHT PSYCHIATRY
Active
Other names
Eastern Light Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SCOTT JR. APRN (PRACTICE OWNER)
(208) 313-9590
Entity
Organization
Contact information
Practice address
20 FOUNDRY ST FL 2, CONCORD, NH 03301-5419
(603) 605-0882
(603) 696-3217
Mailing address
333 BLAKES HILL RD, NORTHWOOD, NH 03261-3930
(208) 313-9590
(603) 696-3217
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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