Individual
WESLEY SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., LCMHC
Contact information
Practice address
226 ROCKINGHAM RD, LONDONDERRY, NH 03053-2107
(603) 425-2989
(603) 425-2978
Mailing address
226 ROCKINGHAM RD, LONDONDERRY, NH 03053-2107
(603) 425-2989
(603) 425-2978
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
157
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1409478Y0NH01
BLUE CROSS BLUE SHIELD NH
NH
05
—
30423041
—
NH
Enumeration date
09/22/2006
Last updated
04/05/2012
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