JACK COSTELLO (NPI# 1720355126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720355126 |
| Entity Type | Individual |
| Full Name | JACK COSTELLO |
| Credential | MA |
| Practice Address |
113 Crosby Rd Dover NH 03820-4370 |
| Practice Telephone | 6035169300 |
| Practice Fax Number | 6037409179 |
| Mailing Telephone | 6035169300 |
| Mailing Fax Number | 6037409179 |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
113 CROSBY RD |
| City | DOVER |
| State | NH |
| Zip Code | 03820-4370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205044484 | Linda Ann Baillargeon | Counselor | 113 Crosby Rd, Dover, NH 03820-4370 | 2007-05-19 |
| 1003313479 | Danna Browne | Behavioral Analyst | 113 Crosby Rd, Dover, NH 03820-4370 | 2018-04-11 |
| 1497114573 | Behavioral Health and Developmental Services of Strafford County | Behavioral Analyst | 113 Crosby Rd, Suite One, Dover, NH 03820-4370 | 2016-02-17 |
| 1194196824 | Shelby Debruyn | Counselor | 113 Crosby Rd, Dover, NH 03820-4370 | 2015-10-07 |
| 1023495660 | Katie Elmendorf | Case Management | 113 Crosby Rd, Dover, NH 03820-4370 | 2015-05-04 |
| 1649667098 | Ashley Wilson | Case Management | 113 Crosby Rd, Dover, NH 03820-4370 | 2015-04-23 |
| 1740526987 | Gayle M Perreault | Behavioral Analyst | 113 Crosby Rd, Suite 1, Dover, NH 03820-4370 | 2012-12-17 |
| 1629345947 | Lynne Hegner | Counselor | 113 Crosby Rd, Dover, NH 03820-4370 | 2011-12-01 |
| 1679840078 | Elisa Monahan | Counselor | 113 Crosby Rd, Dover, NH 03820-4370 | 2011-11-30 |
| 1083981492 | Mary Jane Stenslie | Occupational Therapist | 113 Crosby Rd, Dover, NH 03820-4370 | 2011-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831701242 | Kassie Nicole Zukowski | Speech-Language Pathologist | 40 Chestnut St., Unit 3, Dover, NH 03820 | 2020-08-18 |
| 1013537851 | St.pierre Counseling, Pllc | Community/Behavioral Health | 6 Old Rochester Road, Dover, NH 03820 | 2020-04-22 |
| 1790324002 | Mark Boren | Driver | 29 Cornerstone Dr., Dover, NH 03820 | 2020-01-03 |
| 1568963221 | Sarah Hesketh | Speech-Language Pathologist | 61 Locust Street #333, Dover, NH 03820 | 2018-02-27 |
| 1881106524 | Ashley Leighton | Specialist/Technologist | 197 Dover Point Rd, Dover, NH 03820 | 2017-11-03 |
| 1588048854 | Alliance Mental Health and Youth Consultation Services LLC | Counselor | 1 Washington St Ste 318, Dover, NH 03820 | 2015-07-16 |
| 1275920027 | Meredith Ashley Joyce | Counselor | 50 Chesnut St., Dover, NH 03820 | 2015-04-20 |
| 1891182655 | Jodi Alger | Registered Nurse | 113 Crosby Rd Suite 1, Dover, NH 03820 | 2015-04-20 |
| 1497148159 | Laura Anne Forsblad | Counselor | 750 Central Ave Ste Us, Dover, NH 03820 | 2015-03-05 |
| 1295142867 | Heather M Driscoll | Case Management | 50 Chestnut Street, Suite A, Dover, NH 03820 | 2014-07-16 |
| Find all providers in zip 03820 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649808395 | Nereida Mendez | Counselor | 18 W. Blackwell St, Dover, NJ 07801 | 2020-03-30 |
| 1245864156 | Joan Breault | Counselor | 30 Cataract Ave, Dover, NH 03820-4304 | 2020-02-29 |
| 1336603091 | Ashley Santana | Counselor | 32 West Lookerman Street, Suite #103, Dover, DE 19904 | 2019-01-28 |
| 1427537992 | Barbara Reynolds-vowell | Counselor | 723 Spring St, Dover, TN 37058-3241 | 2018-08-07 |
| 1831613181 | Pylynn Virankabutra | Counselor | 12870 E Us Highway 92 # E044, Dover, FL 33527-4102 | 2017-07-28 |
| 1730602145 | Kathy J Crouch | Counselor | 120 Robertson Hill Rd, Dover, TN 37058-5949 | 2017-07-18 |
| 1073962494 | Kaleishia R Hoskins | Counselor | 91 Wolf Creek Blvd, Dover, DE 19901-4914 | 2016-06-07 |
| 1821443680 | Nicole L Taylor Justice | Counselor | 9 E Loockerman St Ste 302, Dover, DE 19901-8305 | 2016-04-29 |
| 1396118386 | Darcy Winward | Counselor | 1 Washington St Ste 3101, Dover, NH 03820-2231 | 2015-11-12 |
| 1588048854 | Alliance Mental Health and Youth Consultation Services LLC | Counselor | 1 Washington St Ste 318, Dover, NH 03820 | 2015-07-16 |
| Find all providers in DOVER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.