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Individual

MARIELLEN D. LEPAGE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
445 CYPRESS STREET, MANCHESTER COUNSELING SERVICES SUITE 8, MANCHESTER, NH 03103
(603) 668-4079
(603) 663-8605
Mailing address
445 CYPRESS STREET, MANCHESTER COUNSELING SERVICES SUITE 8, MANCHESTER, NH 03103
(603) 668-4079
(603) 663-8605

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1023
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14Y001353MA04
ANTHEM ACES #
NH
01
2058358
CIGNA BH PIN
NH
01
387285
MVP PIN
NH
Enumeration date
03/23/2006
Last updated
07/08/2007
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