Basic Information
Provider Information
NPI: 1033399050
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALIPEAULT
FirstName: JAMES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 PROSPECT STREET
Address2:  
City: NASHUA
State: NH
PostalCode: 03060
CountryCode: US
TelephoneNumber: 6038896147
FaxNumber: 6038831568
Practice Location
Address1: 7 PROSPECT STREET
Address2:  
City: NASHUA
State: NH
PostalCode: 03060
CountryCode: US
TelephoneNumber: 6038896147
FaxNumber: 6038831568
Other Information
ProviderEnumerationDate: 11/07/2007
LastUpdateDate: 10/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  N Other Service ProvidersCase Manager/Care Coordinator 
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
1041C0700X1956NHY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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