Basic Information
| Provider Information | |||||||||
| NPI: | 1285985192 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARSTON | ||||||||
| FirstName: | JAMES CARLETON | ||||||||
| MiddleName: | FRANCIS | ||||||||
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| Credential: | MA, LCMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1592 | ||||||||
| Address2: | |||||||||
| City: | RAYMOND | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030773592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032299165 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10 MEMBERS WAY | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | DOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037429200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2012 | ||||||||
| LastUpdateDate: | 06/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | NH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 3091238 | 05 | NH | MEDICAID |