Individual
JILL MORIARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA.,LCMHC
Contact information
Practice address
67 WATER ST, SUITE #205, LACONIA, NH 03246-3300
(603) 455-1708
(603) 253-9917
Mailing address
PO BOX 514, CENTER HARBOR, NH 03226-0514
(603) 455-1708
(603) 253-9917
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
595
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30426883
—
NH
01
—
7706646Y0NH01
ANTHEM
NH
01
—
889985A
MVP HEALTHCARE
NH
Enumeration date
12/20/2006
Last updated
07/17/2009
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