Organization
DEER CREEK PSYCHOLOGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND J. CHIN PHD (PRESIDENT)
(603) 643-9252
Entity
Organization
Contact information
Practice address
45 LYME RD, SUITE 202A, HANOVER, NH 03755-1219
(802) 785-2543
(802) 785-2631
Mailing address
PO BOX 266, EAST THETFORD, VT 05043-0266
(802) 785-2903
(802) 785-2631
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062-19470
VT BLUECROSS BLUESHIELD
VT
01
—
50Y303300VT01
ANTHEM BCBS
NH
Enumeration date
08/17/2006
Last updated
10/21/2014
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