Organization
KEARSARGE VALLEY COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS WENGER LICSW (OWNER/PROVIDER)
(802) 230-7760
Entity
Organization
Contact information
Practice address
136 STONE BRIDGE RD, WILMOT, NH 03287-4626
(802) 230-7760
Mailing address
PO BOX 12, WILMOT, NH 03287-0012
(802) 230-7760
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/26/2023
Last updated
01/12/2024
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